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Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Generalized AI Output Scenario

Example how the IG can be used only using the generalized Output for elements without specified Resources.

AI Output: Diagnostic Report

The diagnostic report generated by the AI system from the patient's input observation.

ArtifactAssessment: Human Validation

The human oversight assessment recording the clinician's review and validation of the AI-generated diagnostic report.

AuditEvent: AI Diagnostic Report Generation

The audit trail entry recording the AI system's generation of the diagnostic report.

Communication: Patient Explanation

The communication informing the patient about the AI's involvement in generating the diagnostic report and its subsequent human review.

Device: DiagnosticAssist AI

The AI system that generates the diagnostic report from the patient's clinical findings.

EU Conformity Declaration

The conformity declaration document for the AI device used in this diagnostic report scenario.

Input Observation: C-Reactive Protein

The clinical finding used as input to the AI system when generating the diagnostic report.

Model Card: DiagnosticAssist AI

The model card describing the AI system's performance, training data, and privacy characteristics.

Organization: Example Diagnostic Center

The diagnostic center that owns and operates the AI system used to generate the diagnostic report.

Patient: Diagnostic Report Scenario

The patient who is the subject of the AI-generated diagnostic report.

Practitioner: Diagnostic Reviewer

The clinician who performs human oversight and validates the AI-generated diagnostic report.

PractitionerRole: Diagnostic Reviewer

The role held by the practitioner when reviewing AI-generated diagnostic reports at the organization.

Provenance: AI Diagnostic Report

The provenance record describing how and under what legal basis the AI-generated diagnostic report was produced.

Spezialied AI Output Scenario

Example how the spezialized AI Output such as AI Observation can be used.

AI Output: Early Warning Risk Assessment (1)

Synthetic AI-generated high-risk output derived from NEWS2-inspired input parameters.

AI Output: Early Warning Risk Assessment (2)

Synthetic AI-generated high-risk output derived from NEWS2-inspired input parameters.

AI Output: Early Warning Risk Assessment (3)

Synthetic AI-generated low-risk output derived from NEWS2-inspired input parameters.

AI Output: Early Warning Risk Assessment (4)

Synthetic AI-generated low-risk output derived from NEWS2-inspired input parameters.

Assessment: Human Correction of AI Output (4)

Synthetic human oversight assessment documenting the clinician's review of the AI output.

Assessment: Human Override of AI Output (3)

Synthetic human oversight assessment documenting the clinician's review of the AI output.

Assessment: Human Validation of AI Output (2)

Synthetic human oversight assessment documenting the clinician's review of the AI output.

Audit Log: AI Execution Trace (1)

Synthetic audit event documenting the AI execution for PoC traceability.

Audit Log: AI Execution Trace (2)

Synthetic audit event documenting the AI execution for PoC traceability.

Audit Log: AI Execution Trace (3)

Synthetic audit event documenting the AI execution for PoC traceability.

Audit Log: AI Execution Trace (4)

Synthetic audit event documenting the AI execution for PoC traceability.

Communication: Patient-Facing AI Explanation (4)

Synthetic patient-facing explanation about AI-supported processing and human review.

Corrected Clinical Observation: Early Warning Risk Assessment (4)

Human-corrected clinical result preserving traceability to the original AI-generated output.

Device: RiskAssist AI

Synthetic AI system for NEWS2-inspired early-warning risk assessment.

Encounter: Acute Care Assessment

Synthetic encounter for suspected infection and early-warning risk assessment.

EU Conformity Declaration
Input Observation: Blood Pressure (1)

Synthetic NEWS2-inspired input parameter.

Input Observation: Blood Pressure (2)

Synthetic NEWS2-inspired input parameter.

Input Observation: Blood Pressure (3)

Synthetic NEWS2-inspired input parameter.

Input Observation: Blood Pressure (4)

Synthetic NEWS2-inspired input parameter.

Input Observation: Body Temperature (1)

Synthetic NEWS2-inspired input parameter.

Input Observation: Body Temperature (2)

Synthetic NEWS2-inspired input parameter.

Input Observation: Body Temperature (3)

Synthetic NEWS2-inspired input parameter.

Input Observation: Body Temperature (4)

Synthetic NEWS2-inspired input parameter.

Input Observation: Consciousness Status (1)

Synthetic NEWS2-inspired input parameter.

Input Observation: Consciousness Status (2)

Synthetic NEWS2-inspired input parameter.

Input Observation: Consciousness Status (3)

Synthetic NEWS2-inspired input parameter.

Input Observation: Consciousness Status (4)

Synthetic NEWS2-inspired input parameter.

Input Observation: Heart Rate (1)

Synthetic NEWS2-inspired input parameter.

Input Observation: Heart Rate (2)

Synthetic NEWS2-inspired input parameter.

Input Observation: Heart Rate (3)

Synthetic NEWS2-inspired input parameter.

Input Observation: Heart Rate (4)

Synthetic NEWS2-inspired input parameter.

Input Observation: Oxygen Saturation (1)

Synthetic NEWS2-inspired input parameter.

Input Observation: Oxygen Saturation (2)

Synthetic NEWS2-inspired input parameter.

Input Observation: Oxygen Saturation (3)

Synthetic NEWS2-inspired input parameter.

Input Observation: Oxygen Saturation (4)

Synthetic NEWS2-inspired input parameter.

Input Observation: Respiratory Rate (1)

Synthetic NEWS2-inspired input parameter.

Input Observation: Respiratory Rate (2)

Synthetic NEWS2-inspired input parameter.

Input Observation: Respiratory Rate (3)

Synthetic NEWS2-inspired input parameter.

Input Observation: Respiratory Rate (4)

Synthetic NEWS2-inspired input parameter.

Manufacturer Organization: ExampleMed AI GmbH

The fictional manufacturer/provider of the RiskAssist AI system.

Model Card: RiskAssist AI v1.0.0

Synthetic model card for the deterministic AI-output simulation component used in the PoC.

Operator Organization: Example Hospital

The fictional healthcare organization operating the AI system.

Patient: Synthetic Patient 001

A fictional female patient used in the NEWS2-inspired PoC scenarios.

Practitioner: Human Reviewer

The fictional clinician responsible for reviewing the AI-generated output.

PractitionerRole: Human Reviewer

Synthetic practitioner role representing a trained internal medicine reviewer.

Provenance: AI Output Generation (1)

Synthetic provenance resource linking the AI output to the AI system, input data, and legal processing context.

Provenance: AI Output Generation (2)

Synthetic provenance resource linking the AI output to the AI system, input data, and legal processing context.

Provenance: AI Output Generation (3)

Synthetic provenance resource linking the AI output to the AI system, input data, and legal processing context.

Provenance: AI Output Generation (4)

Synthetic provenance resource linking the AI output to the AI system, input data, and legal processing context.

Provenance: Secondary Use Example

Example showing EHDS secondary use purpose and data permit.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Trust AI Act Model Card

A DocumentReference profile representing technical documentation about an AI system, such as intended use, limitations, risk-related information, performance-related information, and model documentation.

Trust AI Data

A resource-independent profile indicating that an AI system was involved in generating, reporting, assisting with, or asserting the content of a FHIR resource.

This profile is intended as a common validation and documentation pattern across different FHIR resource types.

Trust AI Execution Audit Event

An AuditEvent profile documenting execution-related metadata of an AI-supported processing event to support retrospective reconstruction and auditability.

Trust AI Generated Observation

An Observation profile representing a clinical output generated by an AI system, including AI-related transparency metadata and links to the relevant patient, encounter, and AI system.

Trust AI Human Oversight Assessment

An ArtifactAssessment profile documenting professional review of an AI-generated output, including whether the result was accepted, corrected, modified, or overridden.

Trust AI Patient Explanation Communication

A Communication profile documenting that an explanation regarding an AI-supported clinical decision was provided to a patient. The explanation may describe the role of the AI system, the related human oversight, and the key elements of the resulting clinical decision in accordance with Article 86 of the Trust AI Act.

Trust AI Practitioner Role

A PractitionerRole profile representing the role, qualification context, specialty, and AI-related training information of the human reviewer involved in oversight of an AI-supported workflow.

Trust AI Provenance

A Provenance profile linking an AI-generated output to the contributing AI system, source data, and relevant processing or governance context.

Trust AI Responsible Organization

An Organization profile representing an organization involved in manufacturing, providing, deploying, or operating an AI system, including relevant accountability and contact information.

Trust AI System Device

A Device profile representing an AI system or software component, including system identification, versioning, intended purpose, and selected regulatory documentation metadata.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

AI Clinical Validation Status

Records the documented validation status of the AI system, such as clinically validated, under clinical validation, technically validated only, or not clinically validated.

AI Performance Metrics

Documents quantitative performance measures and optional disclosures concerning bias, subgroup performance, or limitations of the evaluation.

AI Retention Information

Documents the stated retention duration for AI-related data, outputs, logs, or documentation.

AI System-Specific Training Status

Records whether the practitioner acting in the documented role has completed training specific to the relevant AI system.

AI Training Data Metadata

Documents the origin, relevant EHDS-related classifications, applicable permit identifiers, secondary-use purposes, and reported quality characteristics of data used to train or develop the AI system.

Automated Decision-Making Flag

Indicates whether the documented AI-supported processing resulted in a decision made solely by automated means.

Case-Specific Indication

Records the clinical indication or case-specific reason for applying the AI system in the documented patient context.

Data Permit

Records the identifier of an EHDS data permit associated with the documented secondary use, where applicable.

EU Conformity Declaration Reference

The EU declaration of conformity shall identify the high-risk AI system.

Model Card Reference

References the model card that documents the AI system's intended purpose, limitations, performance, risks, and other relevant technical information.

Patient AI Info Provided Flag

This flag represents whether the patient has been informed about the AI-related processing activity

Secondary Use Purpose

Records the documented purpose for secondary use of electronic health data in the EHDS context.

Third-Country Data Transfer

Documents whether use of the AI system involves a transfer of personal data to a third country or an international organisation and identifies the destination country or countries where applicable.

Trust AI DPIA Reference

Privacy risk management, GDPR accountability

Trust AI Log Integrity Signature

Provides a digital signature and associated metadata to support verification of the integrity and origin of the AI execution audit record.

Usage Category

Classifies the documented use of electronic health data as primary use or secondary use in the EHDS context.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Data Category Value Set

Categories of electronic health data that may be documented for secondary-use and AI-development contexts.

GDPR Article 6 Legal Basis Value Set

Legal bases listed in Article 6(1) GDPR for documenting the asserted lawful basis for processing personal data.

GDPR Article 9 Condition Value Set

Selected Article 9(2) GDPR conditions relevant to processing health data and other special categories of personal data in this implementation guide.

Secondary-Use Purpose Value Set

Purpose categories used to document the secondary use of electronic health data under the EHDS.

Trust AI Audit Entity Role Value Set

Roles of entities involved in an AI execution audit event.

Trust AI Case-Specific Indication Value Set

Clinical purposes for applying an AI system in an individual care context.

Trust AI Clinical Validation Status Value Set

Clinical validation statuses applicable to an AI system and its documented intended use.

Trust AI Data Quality Value Set

Assessed data-quality characteristics relevant to AI-system development, validation, testing, or evaluation.

Trust AI Human Oversight Action Value Set

Human oversight actions that may be documented in relation to an AI-generated output or recommendation.

Trust AI Involvement Value Set

Codes used to classify how an AI system contributed to the content of a FHIR resource.

Trust AI Performance Metric Value Set

Performance characteristics that may be documented for an AI system.

Usage Category Value Set

Categories distinguishing primary and secondary use of electronic health data in the EHDS context.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Data Category Code System

Codes representing categories of electronic health data that may be made available for secondary use under the EHDS.

GDPR Article 6 Legal Basis Code System

Codes representing the legal bases listed in Article 6(1) GDPR for processing personal data.

GDPR Article 9 Condition Code System

Codes representing selected conditions in Article 9(2) GDPR under which special categories of personal data may be processed.

Secondary-Use Purpose Code System

Codes representing permitted categories of purpose for the secondary use of electronic health data under the EHDS.

Trust AI Artifact Type Code System

Codes identifying AI-related documentation artifacts represented by this implementation guide.

Trust AI Audit Entity Role Code System

Roles used to distinguish entities involved in an AI execution audit event.

Trust AI Case-Specific Indication Code System

Codes describing the clinical purpose for which an AI system was applied in an individual case.

Trust AI Clinical Validation Status Code System

Codes indicating the documented clinical validation status of an AI system for its intended clinical use.

Trust AI Contact Purpose Code System

Codes identifying organizational contact responsibilities relevant to data protection and AI-system governance.

Trust AI Data Quality Code System

Codes describing assessed data-quality characteristics relevant to the development, validation, testing, or evaluation of an AI system.

Trust AI Human Oversight Code System

Codes describing actions taken by a human reviewer in response to an AI-generated output or recommendation.

Trust AI Identifier Type Code System

Codes identifying regulatory identifier types associated with an AI system.

Trust AI Involvement Code System

Codes indicating the manner in which an AI system contributed to the content represented by a FHIR resource.

Trust AI Performance Metric Code System

Codes identifying performance characteristics used to document the evaluation of an AI system.

Trust AI System Property Code System

Codes identifying structured properties used to describe regulatory and operational characteristics of an AI system in Device.property.

Usage Category Code System

Codes distinguishing primary use from secondary use of electronic health data in the context of the European Health Data Space.