Nictiz STU3 Zib 2017 | HCIM AdvanceDirective

Zib AdvanceDirective (Consent)	I		Consent	Element id Consent Short description LivingWill Alternate names Wilsverklaring Definition A record of a healthcare consumer’s policy choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives. Data type Consent Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative `contained.text.empty()` dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource `contained.where(('#'+id in %resource.descendants().reference).not()).empty()` ppc-1: Either a Policy or PolicyRule `policy.exists() or policyRule.exists()` Mappings rim: Entity. Role, or Act rim: FinancialConsent w5: infrastructure.information hcim-advancedirective-v1.0-2015EN: NL-CM:7.15.1 hcim-advancedirective-v3.0-2016EN: NL-CM:7.15.1 hcim-advancedirective-v3.1-2017EN: NL-CM:7.15.1
id	Σ	0..1	id	There are no (further) constraints on this element Element id Consent.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type id
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Consent.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. Data type Meta
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Consent.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. Data type uri
language		0..1	codeBinding	There are no (further) constraints on this element Element id Consent.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. Common Languages (extensible)
text	I	0..1	Narrative	There are no (further) constraints on this element Element id Consent.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. Data type Narrative Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Consent.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Data type Resource Mappings rim: N/A
extension		0..*	Extension	Element id Consent.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Mappings rim: N/A
disorder	I	0..*	Extension(Reference(Zib Problem))	Element id Consent.extension:disorder Short description Disorder Alternate names extensions, user content, Aandoening Definition The problem or disorder to which the living will applies. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Reference(Zib Problem)) Extension URL http://nictiz.nl/fhir/StructureDefinition/zib-AdvanceDirective-Disorder Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a hcim-advancedirective-v1.0-2015EN: NL-CM:7.15.4 hcim-advancedirective-v3.0-2016EN: NL-CM:7.15.4 hcim-advancedirective-v3.1-2017EN: NL-CM:7.15.4
comment	I	0..1	Extension(string)	Element id Consent.extension:comment Short description Comment Alternate names extensions, user content, Toelichting Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(string) Extension URL http://nictiz.nl/fhir/StructureDefinition/Comment Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A rim: n/a hcim-advancedirective-v1.0-2015EN: NL-CM:7.15.6 hcim-advancedirective-v3.0-2016EN: NL-CM:7.15.6 hcim-advancedirective-v3.1-2017EN: NL-CM:7.15.6
modifierExtension	?!	0..*	Extension	There are no (further) constraints on this element Element id Consent.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
identifier	Σ	0..1	Identifier	Element id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier is identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data type Identifier Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim: .id w5: id hcim-basicelements-v1.0-2017EN: NL-CM:0.0.6
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Consent.status Short description draft \| proposed \| active \| rejected \| inactive \| entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid. Data type code Binding Indicates the state of the consent ConsentState (required) Mappings v2: HL7 Table 0498 - Consent Status rim: .statusCode w5: status
category	Σ	2..*	CodeableConcept	Element id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. Data type CodeableConcept Sliced: Unordered, Open, by $this(Value) Binding A classification of the type of consents found in a consent statement Consent Category Codes (example) Mappings rim: CNTRCT w5: class
livingWill	Σ	1..1	CodeableConceptPattern	Element id Consent.category:livingWill Short description Living will and advance directive record Definition Category SNOMED code used for indexing/retrieval of the HCIM AdvanceDirective. Data type CodeableConcept Binding A classification of the type of consents found in a consent statement Consent Category Codes (example) Pattern { "coding": [ { "system": "http://snomed.info/sct", "code": "11341000146107" } ] } Mappings rim: CNTRCT w5: class
id		0..1	string	There are no (further) constraints on this element Element id Consent.category:livingWill.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.category:livingWill.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
coding	Σ	0..*	CodingPattern	There are no (further) constraints on this element Element id Consent.category:livingWill.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Pattern { "system": "http://snomed.info/sct", "code": "11341000146107" } Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Consent.category:livingWill.coding.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.category:livingWill.coding.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
system	Σ	0..1	uriPattern	There are no (further) constraints on this element Element id Consent.category:livingWill.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Pattern http://snomed.info/sct Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.category:livingWill.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	0..1	codePattern	There are no (further) constraints on this element Element id Consent.category:livingWill.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Pattern 11341000146107 Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	Element id Consent.category:livingWill.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Default value Living will and advance directive record (record artifact) Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.category:livingWill.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.category:livingWill.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
typeOfLivingWill	Σ	1..1	CodeableConceptBinding	Element id Consent.category:typeOfLivingWill Short description TypeOfLivingWill Alternate names WilsverklaringType Definition List of the different types of living wills. Data type CodeableConcept Binding List of the different types of living wills. WilsverklaringTypeCodelijst (required) Mappings rim: CNTRCT w5: class hcim-advancedirective-v1.0-2015EN: NL-CM:7.15.2 hcim-advancedirective-v3.0-2016EN: NL-CM:7.15.2 hcim-advancedirective-v3.1-2017EN: NL-CM:7.15.2
id		0..1	string	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
coding	Σ	1..*	Coding	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Comments Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Data type Coding Mappings v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
id		0..1	string	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.coding.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.coding.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
system	Σ	1..1	uri	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.coding.system Short description Identity of the terminology system Definition The identification of the code system that defines the meaning of the symbol in the code. Requirements Need to be unambiguous about the source of the definition of the symbol. Comments The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. Data type uri Mappings v2: CE.3 rim:* ./codeSystem orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
version	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.coding.version Short description Version of the system - if relevant Definition The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Comments Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Data type string Mappings v2: CE.7 rim:* ./codeSystemVersion orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
code	Σ	1..1	code	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.coding.code Short description Symbol in syntax defined by the system Definition A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Requirements Need to refer to a particular code in the system. Data type code Mappings v2: CE.1 rim:* ./code orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.coding.display Short description Representation defined by the system Definition A representation of the meaning of the code in the system, following the rules of the system. Requirements Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Data type string Mappings v2: CE.2 - but note this is not well followed rim:* CV.displayName orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
userSelected	Σ	0..1	boolean	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.coding.userSelected Short description If this coding was chosen directly by the user Definition Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). Requirements This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Comments Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Data type boolean Mappings v2: Sometimes implied by being first rim: CD.codingRationale orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
text	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.category:typeOfLivingWill.text Short description Plain text representation of the concept Definition A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. Requirements The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Comments Very often the text is the same as a displayName of one of the codings. Data type string Mappings v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
patient	Σ	1..1	Reference(nl-core-patient)	Element id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data type Reference(nl-core-patient) Mappings rim: Role w5: who.focus
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Consent.period Short description Period that this consent applies Definition Relevant time or time-period when this Consent is applicable. Comments This can be a subset of the period of the original statement. Meaning when missing all date ranges included Data type Period Mappings rim: FinancialConsent activityTime w5: when.done
dateTime	Σ	1..1	dateTime	Element id Consent.dateTime Short description LivingWillDate Alternate names WilsverklaringDatum Definition The date on which the living will was recorded. Comments This is not the time of the original consent, but the time that this statement was made or derived. Data type dateTime Mappings rim: FinancialConsent effectiveTime w5: when.recorded hcim-advancedirective-v1.0-2015EN: NL-CM:7.15.7 hcim-advancedirective-v3.0-2016EN: NL-CM:7.15.7 hcim-advancedirective-v3.1-2017EN: NL-CM:7.15.7 hcim-basicelements-v1.0-2017EN: NL-CM:0.0.14
consentingParty	Σ	0..1	Reference(nl-core-relatedperson)	Element id Consent.consentingParty Short description Representative Alternate names consentor, Vertegenwoordiger Definition The person who is the legal representative or is appointed as the authorized representative in the signed authorization. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data type Reference(nl-core-relatedperson) Mappings w5: who.actor hcim-advancedirective-v1.0-2015EN: NL-CM:7.15.3 hcim-advancedirective-v3.0-2016EN: NL-CM:7.15.3 hcim-advancedirective-v3.1-2017EN: NL-CM:7.15.3
actor	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Consent.actor Short description Who\|what controlled by this consent (or group, by role) Definition Who or what is controlled by this consent. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Meaning when missing There is no specific actor associated with the consent Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings w5: who.actor
id		0..1	string	There are no (further) constraints on this element Element id Consent.actor.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.actor.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id Consent.actor.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Consent.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the consent. Data type CodeableConcept Binding How an actor is involved in the consent considerations SecurityRoleType (extensible)
reference		1..1	Reference(Device \| Group \| CareTeam \| nl-core-organization \| nl-core-patient \| nl-core-practitioner \| nl-core-relatedperson)	Element id Consent.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data type Reference(Device \| Group \| CareTeam \| nl-core-organization \| nl-core-patient \| nl-core-practitioner \| nl-core-relatedperson)
id		0..1	string	There are no (further) constraints on this element Element id Consent.actor.reference.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	Element id Consent.actor.reference.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
practitionerRole	I	0..1	Extension(Reference(nl-core-practitionerrole))	Element id Consent.actor.reference.extension:practitionerRole Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Reference(nl-core-practitionerrole)) Extension URL http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
reference	Σ I	0..1	string	There are no (further) constraints on this element Element id Consent.actor.reference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Consent.actor.reference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Data type Identifier Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.actor.reference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Mappings rim: N/A
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Consent.action Short description Actions controlled by this consent Definition Actions controlled by this consent. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Meaning when missing all actions Data type CodeableConcept Binding Detailed codes for the consent action. Consent Action Codes (example)
organization	Σ	0..*	Reference(nl-core-organization)	Element id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Data type Reference(nl-core-organization) Mappings w5: who.witness
source[x]	Σ	0..1		Element id Consent.source[x] Short description LivingWillDocument Alternate names WilsverklaringDocument Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Mappings hcim-advancedirective-v1.0-2015EN: NL-CM:7.15.5 hcim-advancedirective-v3.0-2016EN: NL-CM:7.15.5 hcim-advancedirective-v3.1-2017EN: NL-CM:7.15.5
sourceAttachment			Attachment	There are no (further) constraints on this element Data type Attachment
sourceIdentifier			Identifier	There are no (further) constraints on this element Data type Identifier
sourceReference			Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse)	There are no (further) constraints on this element Data type Reference(Consent \| DocumentReference \| Contract \| QuestionnaireResponse)
policy		0..*	BackboneElement	There are no (further) constraints on this element Element id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Consent.policy.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.policy.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id Consent.policy.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
authority	I	0..1	uri	There are no (further) constraints on this element Element id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Data type uri
uri	I	0..1	uri	Element id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments Either `.policy` or `.policyRule` should exist following core constraint ppc-1. If no explicit value is recorded, a fallback is to populate `.policy.uri` with https://wetten.overheid.nl/ if the advance directive is recorded following Dutch law and regulations. Data type uri Examples General Dutch Law http://wetten.overheid.nl/
policyRule	Σ I	0..1	uri	There are no (further) constraints on this element Element id Consent.policyRule Short description Policy that this consents to Definition A referece to the specific computable policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource. Data type uri
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id Consent.securityLabel Short description Security Labels that define affected resources Definition A set of security labels that define which resources are controlled by this consent. If more than one label is specified, all resources must have all the specified labels. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?). Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id Consent.purpose Short description Context of activities for which the agreement is made Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this consent. Comments This element is for discoverability / documentation, and does not modify or qualify the policy (e.g. the policy itself describes the purposes for which it applies). Data type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels PurposeOfUse (extensible)
dataPeriod	Σ	0..1	Period	There are no (further) constraints on this element Element id Consent.dataPeriod Short description Timeframe for data controlled by this consent Definition Clinical or Operational Relevant period of time that bounds the data controlled by this consent. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data type Period
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Consent.data Short description Data controlled by this consent Definition The resources controlled by this consent, if specific resources are referenced. Meaning when missing all data Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: Role
id		0..1	string	There are no (further) constraints on this element Element id Consent.data.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.data.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id Consent.data.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Consent.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Data type code Binding How a resource reference is interpreted when testing consent restrictions ConsentDataMeaning (required)
reference	Σ	1..1	Reference(Resource)	There are no (further) constraints on this element Element id Consent.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Data type Reference(Resource)
except	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Consent.except Short description Additional rule - addition or removal of permissions Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Consent.except.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.except.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id Consent.except.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
type	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Consent.except.type Short description deny \| permit Definition Action to take - permit or deny - when the exception conditions are met. Data type code Binding How an exception statement is applied, such as adding additional consent or removing consent ConsentExceptType (required)
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Consent.except.period Short description Timeframe for this exception Definition The timeframe in this exception is valid. Data type Period
actor	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Consent.except.actor Short description Who\|what controlled by this exception (or group, by role) Definition Who or what is controlled by this Exception. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Meaning when missing There is no specific actor associated with the exception Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Consent.except.actor.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.except.actor.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id Consent.except.actor.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Consent.except.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Data type CodeableConcept Binding How an actor is involved in the consent considerations SecurityRoleType (extensible)
reference		1..1	Reference(Device \| Group \| CareTeam \| nl-core-organization \| nl-core-patient \| nl-core-practitioner \| nl-core-relatedperson)	Element id Consent.except.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Data type Reference(Device \| Group \| CareTeam \| nl-core-organization \| nl-core-patient \| nl-core-practitioner \| nl-core-relatedperson)
id		0..1	string	There are no (further) constraints on this element Element id Consent.except.actor.reference.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	Element id Consent.except.actor.reference.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings rim: n/a
practitionerRole	I	0..1	Extension(Reference(nl-core-practitionerrole))	Element id Consent.except.actor.reference.extension:practitionerRole Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension(Reference(nl-core-practitionerrole)) Extension URL http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
reference	Σ I	0..1	string	There are no (further) constraints on this element Element id Consent.except.actor.reference.reference Short description Literal reference, Relative, internal or absolute URL Definition A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Comments Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Data type string Mappings rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Consent.except.actor.reference.identifier Short description Logical reference, when literal reference is not known Definition An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. Comments When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Data type Identifier Mappings rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Consent.except.actor.reference.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Data type string Mappings rim: N/A
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Consent.except.action Short description Actions controlled by this exception Definition Actions controlled by this Exception. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Meaning when missing all actions Data type CodeableConcept Binding Detailed codes for the consent action. Consent Action Codes (example)
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id Consent.except.securityLabel Short description Security Labels that define affected resources Definition A set of security labels that define which resources are controlled by this exception. If more than one label is specified, all resources must have all the specified labels. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?). Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible)
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id Consent.except.purpose Short description Context of activities covered by this exception Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this exception. Comments E.g. if the purpose is 'research', then the operational context must be research, in order for the consent to apply. Not all of the security labels make sense for use in this element (may define a narrower value set?). Data type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels PurposeOfUse (extensible)
class	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id Consent.except.class Short description e.g. Resource Type, Profile, or CDA etc Definition The class of information covered by this exception. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data type Coding Binding The class (type) of information a consent rule covers Consent Content Class (extensible)
code	Σ	0..*	Coding	There are no (further) constraints on this element Element id Consent.except.code Short description e.g. LOINC or SNOMED CT code, etc in the content Definition If this code is found in an instance, then the exception applies. Comments Typical use of this is a Document code with class = CDA. Data type Coding Binding If this code is found in an instance, then the exception applies Consent Content Codes (example)
dataPeriod	Σ	0..1	Period	There are no (further) constraints on this element Element id Consent.except.dataPeriod Short description Timeframe for data controlled by this exception Definition Clinical or Operational Relevant period of time that bounds the data controlled by this exception. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data type Period
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element id Consent.except.data Short description Data controlled by this exception Definition The resources controlled by this exception, if specific resources are referenced. Meaning when missing all data Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() \| (children().count() > id.count())` Mappings rim: Role
id		0..1	string	There are no (further) constraints on this element Element id Consent.except.data.id Short description xml:id (or equivalent in JSON) Definition unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension		0..*	Extension	There are no (further) constraints on this element Element id Consent.except.data.extension Short description Additional Content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: n/a
modifierExtension	Σ ?!	0..*	Extension	There are no (further) constraints on this element Element id Consent.except.data.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Mappings rim: N/A
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Consent.except.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Data type code Binding How a resource reference is interpreted when testing consent restrictions ConsentDataMeaning (required)
reference	Σ	1..1	Reference(Resource)	There are no (further) constraints on this element Element id Consent.except.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Data type Reference(Resource)

Documentation:

https://simplifier.net/nictizstu3-zib2017/zib-advancedirective

Last updated on 2/25/2025, 10:41:20 AM

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HCIM AdvanceDirective

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