Written during migration - review before release. TODO:REVIEW English translation produced during migration; the EN guide had no counterpart page. German original: input/translations/de/intro-notes/StructureDefinition-mii-pr-icu-dm-eingestellte-gemessene-parameter-beatmung-intro.md

Recommendation: For measured as well as set values we can distinguish two cases (see also the page Description of module):

1. The device that recorded the measured value / on which a value was set is known and is to be modelled.

2. The device is not known and cannot be modelled, or the device is known but cannot/should not be modelled.

The information whether a value is measured or set is carried by the DeviceMetric; the information which device was involved is carried by a Device resource referenced from the DeviceMetric. For the two cases above we propose the following:

1. DeviceMetric and Device for such a measured value belong together. For a group of values sharing a common measurement method and a common device, one shared pair of DeviceMetric and Device can be created and referenced from Observation.device.

2. We propose to initially create two "dummy resources": one DeviceMetric for measured and one for set values. These DeviceMetrics can then be referenced statically in every Observation.device. This carries the minimally required information whether a value is measured or set. The approach can be refined further if needed, e.g. by creating a dedicated DeviceMetric (one each for measured/set) per device type (each referencing a corresponding static Device via DeviceMetric.device).

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DeviceMetric		0..*	DeviceMetric	Measurement, calculation or setting capability of a medical device
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
type	SΣ	1..1	CodeableConcept	Identity of metric, for example Heart Rate or PEEP Setting Binding: MII VS ICU Category Procedure Beatmung SNOMED (required)
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	SΣ	1..1	code	Symbol in syntax defined by the system
source	SΣ	0..1	Reference(MII PR ICU Device)	Describes the link to the source Device
category	SΣ	1..1	code	measurement | setting | calculation | unspecified Binding: DeviceMetricCategory (required): Describes the category of the metric.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DeviceMetric.type	Base	required	MII VS ICU Category Procedure Beatmung SNOMED	📦2027.0.0-ballot.3	This IG
DeviceMetric.category	Base	required	DeviceMetricCategory	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DeviceMetric	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	DeviceMetric	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DeviceMetric	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DeviceMetric	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	DeviceMetric	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DeviceMetric		0..*	DeviceMetric	Measurement, calculation or setting capability of a medical device
type	S	1..1	CodeableConcept	Identity of metric, for example Heart Rate or PEEP Setting Binding: MII VS ICU Category Procedure Beatmung SNOMED (required)
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system	S	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	S	1..1	code	Symbol in syntax defined by the system
source	S	0..1	Reference(MII PR ICU Device)	Describes the link to the source Device
category	S	1..1	code	measurement | setting | calculation | unspecified
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
DeviceMetric.type	Base	required	MII VS ICU Category Procedure Beatmung SNOMED	📦2027.0.0-ballot.3	This IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DeviceMetric		0..*	DeviceMetric	Measurement, calculation or setting capability of a medical device
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Instance identifier
type	SΣ	1..1	CodeableConcept	Identity of metric, for example Heart Rate or PEEP Setting Binding: MII VS ICU Category Procedure Beatmung SNOMED (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
unit	Σ	0..1	CodeableConcept	Unit of Measure for the Metric Binding: DeviceMetricAndComponentTypes (preferred): Describes the unit of the metric.
source	SΣ	0..1	Reference(MII PR ICU Device)	Describes the link to the source Device
parent	Σ	0..1	Reference(Device)	Describes the link to the parent Device
operationalStatus	Σ	0..1	code	on | off | standby | entered-in-error Binding: DeviceMetricOperationalStatus (required): Describes the operational status of the DeviceMetric.
color	Σ	0..1	code	black | red | green | yellow | blue | magenta | cyan | white Binding: DeviceMetricColor (required): Describes the typical color of representation.
category	SΣ	1..1	code	measurement | setting | calculation | unspecified Binding: DeviceMetricCategory (required): Describes the category of the metric.
measurementPeriod	Σ	0..1	Timing	Describes the measurement repetition time
calibration	Σ	0..*	BackboneElement	Describes the calibrations that have been performed or that are required to be performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	code	unspecified | offset | gain | two-point Binding: DeviceMetricCalibrationType (required): Describes the type of a metric calibration.
state	Σ	0..1	code	not-calibrated | calibration-required | calibrated | unspecified Binding: DeviceMetricCalibrationState (required): Describes the state of a metric calibration.
time	Σ	0..1	instant	Describes the time last calibration has been performed
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DeviceMetric.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
DeviceMetric.type	Base	required	MII VS ICU Category Procedure Beatmung SNOMED	📦2027.0.0-ballot.3	This IG
DeviceMetric.unit	Base	preferred	Device Metric and Component Types	📍4.0.1	FHIR Std.
DeviceMetric.operationalStatus	Base	required	DeviceMetricOperationalStatus	📍4.0.1	FHIR Std.
DeviceMetric.color	Base	required	DeviceMetricColor	📍4.0.1	FHIR Std.
DeviceMetric.category	Base	required	DeviceMetricCategory	📍4.0.1	FHIR Std.
DeviceMetric.calibration.​type	Base	required	DeviceMetricCalibrationType	📍4.0.1	FHIR Std.
DeviceMetric.calibration.​state	Base	required	DeviceMetricCalibrationState	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DeviceMetric	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	DeviceMetric	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DeviceMetric	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DeviceMetric	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	DeviceMetric	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DeviceMetric		0..*	DeviceMetric	Measurement, calculation or setting capability of a medical device
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
type	SΣ	1..1	CodeableConcept	Identity of metric, for example Heart Rate or PEEP Setting Binding: MII VS ICU Category Procedure Beatmung SNOMED (required)
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	SΣ	1..1	code	Symbol in syntax defined by the system
source	SΣ	0..1	Reference(MII PR ICU Device)	Describes the link to the source Device
category	SΣ	1..1	code	measurement | setting | calculation | unspecified Binding: DeviceMetricCategory (required): Describes the category of the metric.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DeviceMetric.type	Base	required	MII VS ICU Category Procedure Beatmung SNOMED	📦2027.0.0-ballot.3	This IG
DeviceMetric.category	Base	required	DeviceMetricCategory	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DeviceMetric	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	DeviceMetric	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DeviceMetric	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DeviceMetric	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	DeviceMetric	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DeviceMetric		0..*	DeviceMetric	Measurement, calculation or setting capability of a medical device
type	S	1..1	CodeableConcept	Identity of metric, for example Heart Rate or PEEP Setting Binding: MII VS ICU Category Procedure Beatmung SNOMED (required)
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system	S	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	S	1..1	code	Symbol in syntax defined by the system
source	S	0..1	Reference(MII PR ICU Device)	Describes the link to the source Device
category	S	1..1	code	measurement | setting | calculation | unspecified
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
DeviceMetric.type	Base	required	MII VS ICU Category Procedure Beatmung SNOMED	📦2027.0.0-ballot.3	This IG

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DeviceMetric		0..*	DeviceMetric	Measurement, calculation or setting capability of a medical device
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Instance identifier
type	SΣ	1..1	CodeableConcept	Identity of metric, for example Heart Rate or PEEP Setting Binding: MII VS ICU Category Procedure Beatmung SNOMED (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
unit	Σ	0..1	CodeableConcept	Unit of Measure for the Metric Binding: DeviceMetricAndComponentTypes (preferred): Describes the unit of the metric.
source	SΣ	0..1	Reference(MII PR ICU Device)	Describes the link to the source Device
parent	Σ	0..1	Reference(Device)	Describes the link to the parent Device
operationalStatus	Σ	0..1	code	on | off | standby | entered-in-error Binding: DeviceMetricOperationalStatus (required): Describes the operational status of the DeviceMetric.
color	Σ	0..1	code	black | red | green | yellow | blue | magenta | cyan | white Binding: DeviceMetricColor (required): Describes the typical color of representation.
category	SΣ	1..1	code	measurement | setting | calculation | unspecified Binding: DeviceMetricCategory (required): Describes the category of the metric.
measurementPeriod	Σ	0..1	Timing	Describes the measurement repetition time
calibration	Σ	0..*	BackboneElement	Describes the calibrations that have been performed or that are required to be performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	code	unspecified | offset | gain | two-point Binding: DeviceMetricCalibrationType (required): Describes the type of a metric calibration.
state	Σ	0..1	code	not-calibrated | calibration-required | calibrated | unspecified Binding: DeviceMetricCalibrationState (required): Describes the state of a metric calibration.
time	Σ	0..1	instant	Describes the time last calibration has been performed
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DeviceMetric.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
DeviceMetric.type	Base	required	MII VS ICU Category Procedure Beatmung SNOMED	📦2027.0.0-ballot.3	This IG
DeviceMetric.unit	Base	preferred	Device Metric and Component Types	📍4.0.1	FHIR Std.
DeviceMetric.operationalStatus	Base	required	DeviceMetricOperationalStatus	📍4.0.1	FHIR Std.
DeviceMetric.color	Base	required	DeviceMetricColor	📍4.0.1	FHIR Std.
DeviceMetric.category	Base	required	DeviceMetricCategory	📍4.0.1	FHIR Std.
DeviceMetric.calibration.​type	Base	required	DeviceMetricCalibrationType	📍4.0.1	FHIR Std.
DeviceMetric.calibration.​state	Base	required	DeviceMetricCalibrationState	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DeviceMetric	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	DeviceMetric	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DeviceMetric	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DeviceMetric	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	DeviceMetric	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Summary

Mandatory: 0 element(2 nested mandatory elements)
Must-Support: 6 elements

Structures

This structure refers to these other structures:

• MII PR ICU Device (https://www.medizininformatik-initiative.de/fhir/ext/modul-icu/StructureDefinition/mii-pr-icu-device)