This page is part of the FUT Infrastructure (v11.0.1: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
| Official URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression | Version: 11.0.1 | |||
| Active as of 2026-10-23 | Computable Name: ehealth-clinicalimpression | |||
A record of a clinical assessment performed to determine what problem(s) may affect the patient and before planning the treatments or management strategies that are best to manage a patient's condition. Assessments are often 1:1 with a clinical consultation / encounter, but this varies greatly depending on the clinical workflow. This resource is called "ClinicalImpression" rather than "ClinicalAssessment" to avoid confusion with the recording of assessment tools such as Apgar score.
In scope of the eHealth Infrastructure, the ClinicalImpression resource is used for:
The element code specifies which of the above uses is the case.
The ClinicalImpression can refer to another ClinicalImpression through the element previous. It can also refer to measurement resources such as Observation, QuestionnaireResponse and Media through
a number of investigation.item.
With the extension ehealth-clinicalimpression-decisionContext, the ClinicalImpression is able to capture decision support invocations such as the automated triaging. This entails:
With the extension ehealth-questionnaireresponse-finding-basis, the foundation of the overall ClinicalImpression finding can be expressed.
The extension consists of a list, where each element in the list represents an answer significance which was triggered during triage.
Each element includes the following:
The ClinicalImpression instance for the Practitioner assessment can refer to a ClinicalImpression instance of the other types through the element previous.
The element ehealth-clinicalimpression-decision contains the Practitioner's assessment of the measurement/triaging result/decision support result, that is whether the measurement/result is approved and/or approved for publishing in national document sharing.
In case the Practitioner has comments or notes, these can be captured as one or more occurrences of the element note.text.
The element code must be set to approved-view
The element ehealth-clinicalimpression-decision must be set to citizen-view-approved
The element investigation.ehealth-clinicalimpression-viewInvestigationItem must contain references to the ehealth-views that are approved.
The element investigation.item must contain references to the QuestionnaireResponses that may use the views.
This indicates to the patient solution that the patient referenced in the subject element is allowed to use the InterpretedViews for the specified QuestionnaireResponses.
The ClinicalImpression.ehealth-clinicalimpression-careplan must be set when the ClinicalImpression references a resource that somewhere in the reference chain references a CarePlan.
previous then it must also have the ehealth-clinicalimpression-careplan element set, referring the same CarePlan as the previous ClinicalImpression.A ClinicalImpression is not allowed to concern resources from different CarePlans, for example Observations from different CarePlans.
The element assessorOrganization is automatically set by the infrastructure to reflect the organizational context of the assessor who performed the assessment, when a ClinicalImpression is created to indicate the approval of document sharing.
assessorOrganization will automatically be set to the organizational context of the Practitioner who performed the assessment.assessorOrganization will automatically be set to the CarePlan.author if possible, else it will be the EpisodeOfCare.caremanagerOrganization.Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots, and their representations.
| Path | Status | Usage | ValueSet | Version | Source |
| ClinicalImpression.status | Base | required | Clinical Impression Status | 📍4.0.1 | FHIR Std. |
| ClinicalImpression.code | Base | required | Clinical Impression Codes | 📦11.0.1 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| Path | Status | Usage | ValueSet | Version | Source |
| ClinicalImpression.code | Base | required | Clinical Impression Codes | 📦11.0.1 | This IG |
| ClinicalImpression.investigation.code | Base | example | ClinicalImpression Investigation Item Codes | 📦11.0.1 | This IG |
| ClinicalImpression.finding.itemCodeableConcept | Base | required | ClinicalImpression Finding Codes | 📦11.0.1 | This IG |
| Name | Flags | Card. | Type | Description & Constraints Filter:  | ||||
|---|---|---|---|---|---|---|---|---|
  ClinicalImpression |
0..* | ClinicalImpression | A clinical assessment performed when planning treatments and management strategies for a patient | |||||
  id |
0..1 | id | Logical id of this artifact | |||||
 meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
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.
| |||||
| 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 | |||||
  Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
   extension:assessorOrganization |
0..1 | Reference(ehealth-organization) {r} | Assessors Organization URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-assessor-organization | |||||
| extension:assessorOther |
0..1 | Reference(ehealth-patient | ehealth-relatedperson) {r} | Other assessor URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-assessor-other | |||||
| extension:carePlan |
0..1 | Reference(ehealth-careplan) {r} | The Careplan URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-careplan | |||||
| extension:decisionContext |
0..* | Reference(Parameters) {r, c} | Library and relevant resources used for evaluation URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-decisionContext | |||||
| extension:decision |
0..* | CodeableConcept | approved | approved-for-sharing URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-decision Binding: ClinicalImpression Decision Codes (required) | |||||
 extension:episodeOfCare |
1..1 | (Complex) | Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare | |||||
  id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare" | |||||
  value[x] |
1..1 | Reference(ehealth-episodeofcare) {r} | Value of extension | |||||
 extension:findingBasis |
0..* | (Complex) | The basis for a clinical impression finding URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-questionnaireresponse-finding-basis | |||||
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| identifier |
0..* | Identifier | Business identifier | |||||
| status |
1..1 | code | in-progress | completed | entered-in-error Binding: ClinicalImpressionStatus (required): The workflow state of a clinical impression. | |||||
| statusReason |
0..1 | CodeableConcept | Reason for current status Binding Description: (example): Codes identifying the reason for the current state of a clinical impression. | |||||
| code |
1..1 | CodeableConcept | Kind of assessment performed Binding: Clinical Impression Codes (required) | |||||
| description |
0..1 | string | Why/how the assessment was performed | |||||
| subject |
1..1 | Reference(ehealth-patient) {r} | Patient or group assessed | |||||
| encounter |
0..1 | Reference(Encounter) | Encounter created as part of | |||||
 effective[x] |
0..1 | Time of assessment | ||||||
| effectiveDateTime |
dateTime | |||||||
 effectivePeriod |
Period | |||||||
| date |
0..1 | dateTime | When the assessment was documented | |||||
| assessor |
0..1 | Reference(ehealth-practitioner) {r} | The clinician performing the assessment | |||||
| previous |
0..1 | Reference(ehealth-clinicalimpression) {r} | Reference to last assessment | |||||
| problem |
0..* | Reference(ehealth-condition | AllergyIntolerance) {r} | Relevant impressions of patient state | |||||
| investigation |
0..* | BackboneElement | One or more sets of investigations (signs, symptoms, etc.) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:viewInvestigationItem |
0..* | Reference(ehealth-view) {r} | View item URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-viewInvestigationItem | |||||
| extension:otherItem |
0..* | Reference(ehealth-clinicalimpression | ehealth-provenance) {r} | Other item URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-otherItem | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConcept | A name/code for the set Binding: ClinicalImpression Investigation Item Codes (example) | |||||
| item |
0..* | Reference(ehealth-media | ehealth-observation | ehealth-questionnaireresponse | FamilyMemberHistory | DiagnosticReport | RiskAssessment | ImagingStudy) {r} | Record of a specific investigation | |||||
| protocol |
0..* | uri | Clinical Protocol followed | |||||
| summary |
0..1 | string | Summary of the assessment | |||||
| finding |
0..* | BackboneElement | Possible or likely findings and diagnoses | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| itemCodeableConcept |
0..1 | CodeableConcept | What was found Binding: ClinicalImpression Finding Codes (required) | |||||
| itemReference |
0..1 | Reference(Observation | ehealth-condition) | What was found | |||||
| basis |
0..1 | string | Which investigations support finding | |||||
| prognosisCodeableConcept |
0..* | CodeableConcept | Estimate of likely outcome Binding: ClinicalImpressionPrognosis (example): Prognosis or outlook findings. | |||||
| prognosisReference |
0..* | Reference(RiskAssessment) {r} | RiskAssessment expressing likely outcome | |||||
| supportingInfo |
0..* | Reference(Resource) | Information supporting the clinical impression | |||||
 note |
0..* | Annotation | Comments made about the ClinicalImpression | |||||
 id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
 Slices for author[x] |
0..1 | Individual responsible for the annotation Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | ||||||
| authorReference |
Reference(Practitioner | Patient | RelatedPerson | Organization) | |||||||
| authorString |
string | |||||||
| author[x]:authorReference |
0..1 | Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson) | Individual responsible for the annotation | |||||
| author[x]:authorString |
0..1 | string | Individual responsible for the annotation | |||||
| time |
0..1 | dateTime | When the annotation was made | |||||
| text |
1..1 | markdown | The annotation - text content (as markdown) | |||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| ClinicalImpression.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| ClinicalImpression.status | Base | required | Clinical Impression Status | 📍4.0.1 | FHIR Std. |
| ClinicalImpression.statusReason | Base | example | Not State | Unknown | |
| ClinicalImpression.code | Base | required | Clinical Impression Codes | 📦11.0.1 | This IG |
| ClinicalImpression.investigation.code | Base | example | ClinicalImpression Investigation Item Codes | 📦11.0.1 | This IG |
| ClinicalImpression.finding.itemCodeableConcept | Base | required | ClinicalImpression Finding Codes | 📦11.0.1 | This IG |
| ClinicalImpression.prognosisCodeableConcept | Base | example | Clinical Impression Prognosis | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
Summary
Mandatory: 3 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Key Elements View
| Path | Status | Usage | ValueSet | Version | Source |
| ClinicalImpression.status | Base | required | Clinical Impression Status | 📍4.0.1 | FHIR Std. |
| ClinicalImpression.code | Base | required | Clinical Impression Codes | 📦11.0.1 | This IG |
| Id | Grade | Path(s) | Description | Expression |
Differential View
| Path | Status | Usage | ValueSet | Version | Source |
| ClinicalImpression.code | Base | required | Clinical Impression Codes | 📦11.0.1 | This IG |
| ClinicalImpression.investigation.code | Base | example | ClinicalImpression Investigation Item Codes | 📦11.0.1 | This IG |
| ClinicalImpression.finding.itemCodeableConcept | Base | required | ClinicalImpression Finding Codes | 📦11.0.1 | This IG |
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| ClinicalImpression |
0..* | ClinicalImpression | A clinical assessment performed when planning treatments and management strategies for a patient | |||||
| id |
0..1 | id | Logical id of this artifact | |||||
| meta |
0..1 | Meta | Metadata about the resource | |||||
| implicitRules |
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.
| |||||
| 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 | |||||
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:assessorOrganization |
0..1 | Reference(ehealth-organization) {r} | Assessors Organization URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-assessor-organization | |||||
| extension:assessorOther |
0..1 | Reference(ehealth-patient | ehealth-relatedperson) {r} | Other assessor URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-assessor-other | |||||
| extension:carePlan |
0..1 | Reference(ehealth-careplan) {r} | The Careplan URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-careplan | |||||
| extension:decisionContext |
0..* | Reference(Parameters) {r, c} | Library and relevant resources used for evaluation URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-decisionContext | |||||
| extension:decision |
0..* | CodeableConcept | approved | approved-for-sharing URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-decision Binding: ClinicalImpression Decision Codes (required) | |||||
| extension:episodeOfCare |
1..1 | (Complex) | Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare" | |||||
| value[x] |
1..1 | Reference(ehealth-episodeofcare) {r} | Value of extension | |||||
| extension:findingBasis |
0..* | (Complex) | The basis for a clinical impression finding URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-questionnaireresponse-finding-basis | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| identifier |
0..* | Identifier | Business identifier | |||||
| status |
1..1 | code | in-progress | completed | entered-in-error Binding: ClinicalImpressionStatus (required): The workflow state of a clinical impression. | |||||
| statusReason |
0..1 | CodeableConcept | Reason for current status Binding Description: (example): Codes identifying the reason for the current state of a clinical impression. | |||||
| code |
1..1 | CodeableConcept | Kind of assessment performed Binding: Clinical Impression Codes (required) | |||||
| description |
0..1 | string | Why/how the assessment was performed | |||||
| subject |
1..1 | Reference(ehealth-patient) {r} | Patient or group assessed | |||||
| encounter |
0..1 | Reference(Encounter) | Encounter created as part of | |||||
| effective[x] |
0..1 | Time of assessment | ||||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| date |
0..1 | dateTime | When the assessment was documented | |||||
| assessor |
0..1 | Reference(ehealth-practitioner) {r} | The clinician performing the assessment | |||||
| previous |
0..1 | Reference(ehealth-clinicalimpression) {r} | Reference to last assessment | |||||
| problem |
0..* | Reference(ehealth-condition | AllergyIntolerance) {r} | Relevant impressions of patient state | |||||
| investigation |
0..* | BackboneElement | One or more sets of investigations (signs, symptoms, etc.) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:viewInvestigationItem |
0..* | Reference(ehealth-view) {r} | View item URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-viewInvestigationItem | |||||
| extension:otherItem |
0..* | Reference(ehealth-clinicalimpression | ehealth-provenance) {r} | Other item URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-clinicalimpression-otherItem | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConcept | A name/code for the set Binding: ClinicalImpression Investigation Item Codes (example) | |||||
| item |
0..* | Reference(ehealth-media | ehealth-observation | ehealth-questionnaireresponse | FamilyMemberHistory | DiagnosticReport | RiskAssessment | ImagingStudy) {r} | Record of a specific investigation | |||||
| protocol |
0..* | uri | Clinical Protocol followed | |||||
| summary |
0..1 | string | Summary of the assessment | |||||
| finding |
0..* | BackboneElement | Possible or likely findings and diagnoses | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| itemCodeableConcept |
0..1 | CodeableConcept | What was found Binding: ClinicalImpression Finding Codes (required) | |||||
| itemReference |
0..1 | Reference(Observation | ehealth-condition) | What was found | |||||
| basis |
0..1 | string | Which investigations support finding | |||||
| prognosisCodeableConcept |
0..* | CodeableConcept | Estimate of likely outcome Binding: ClinicalImpressionPrognosis (example): Prognosis or outlook findings. | |||||
| prognosisReference |
0..* | Reference(RiskAssessment) {r} | RiskAssessment expressing likely outcome | |||||
| supportingInfo |
0..* | Reference(Resource) | Information supporting the clinical impression | |||||
| note |
0..* | Annotation | Comments made about the ClinicalImpression | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for author[x] |
0..1 | Individual responsible for the annotation Slice: Unordered, Closed by type:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | ||||||
| authorReference |
Reference(Practitioner | Patient | RelatedPerson | Organization) | |||||||
| authorString |
string | |||||||
| author[x]:authorReference |
0..1 | Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson) | Individual responsible for the annotation | |||||
| author[x]:authorString |
0..1 | string | Individual responsible for the annotation | |||||
| time |
0..1 | dateTime | When the annotation was made | |||||
| text |
1..1 | markdown | The annotation - text content (as markdown) | |||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| ClinicalImpression.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| ClinicalImpression.status | Base | required | Clinical Impression Status | 📍4.0.1 | FHIR Std. |
| ClinicalImpression.statusReason | Base | example | Not State | Unknown | |
| ClinicalImpression.code | Base | required | Clinical Impression Codes | 📦11.0.1 | This IG |
| ClinicalImpression.investigation.code | Base | example | ClinicalImpression Investigation Item Codes | 📦11.0.1 | This IG |
| ClinicalImpression.finding.itemCodeableConcept | Base | required | ClinicalImpression Finding Codes | 📦11.0.1 | This IG |
| ClinicalImpression.prognosisCodeableConcept | Base | example | Clinical Impression Prognosis | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
Summary
Mandatory: 3 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron
