<status value="draft" /> <date value="2026-01-09" /> <publisher value="HL7 Canada - FHIR Implementation Work Group" /> <contact> <telecom> <system value="url" /> <value value="https://infocentral.infoway-inforoute.ca/en/collaboration/wg/fhir-implementations" /> </telecom> </contact> <description value="Proposed constraints and extensions on the Practitioner Resource for use by Provider Registry systems" /> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166" /> <code value="CA" /> </coding> </jurisdiction> <fhirVersion value="4.0.1" /> <mapping> <identity value="v2" /> <uri value="http://hl7.org/v2" /> <name value="HL7 v2 Mapping" /> </mapping> <mapping> <identity value="rim" /> <uri value="http://hl7.org/v3" /> <name value="RIM Mapping" /> </mapping> <mapping> <identity value="servd" /> <uri value="http://www.omg.org/spec/ServD/1.0/" /> <name value="ServD" /> </mapping> <mapping> <identity value="w5" /> <uri value="http://hl7.org/fhir/fivews" /> <name value="FiveWs Pattern Mapping" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Practitioner" /> <baseDefinition value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner" /> <derivation value="constraint" /> <differential> <element id="Practitioner"> <path value="Practitioner" /> <short value="Practitioner Profile" /> <definition value="The Practitioner Profile is based upon the CA Baseline FHIR Practitioner Profile for general use" /> </element> <element id="Practitioner.extension"> <path value="Practitioner.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Practitioner.extension:deceased"> <path value="Practitioner.extension" /> <sliceName value="deceased" /> <short value="Indicates if the individual is deceased or not." /> <definition value="The fact that a practitioner is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive." /> <comment value="Implementers should recognize that the determination of whether this should be considered a modifierExtension is ongoing. Since Modifier Extensions should have extreme caution in their application and are further nuanced by the use cases in the implementing registry systems, this extension has been shifted back to a regular extension to align to use in existing implementations. Implementers who are considering using this extension in their guidance are required to review the [FHIR Guidance on Modifier Extensions])(https://www.hl7.org/fhir/R4/extensibility.html#modifierExtension) before including this extension in their profile. Implementers should also be aware of the Practitioner.deceased[x] R5 concept and that the CA Baseline is monitoring changes in the element to determine if the approach to this extension requires a shift." /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased" /> </type> </element> <element id="Practitioner.identifier"> <path value="Practitioner.identifier" /> <min value="1" /> <type> <code value="Identifier" /> <profile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-identifier" /> </type> </element> <element id="Practitioner.name"> <path value="Practitioner.name" /> <min value="1" /> </element> <element id="Practitioner.address.extension"> <path value="Practitioner.address.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Practitioner.address.extension:preferred"> <path value="Practitioner.address.extension" /> <sliceName value="preferred" /> <short value="HL7 Preferred Address Flag extension" /> <definition value="Flag denoting whether parent address item is preferred" /> <min value="0" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/iso21090-preferred" /> </type> </element> <element id="Practitioner.qualification"> <path value="Practitioner.qualification" /> <comment value="Slicing has been maintained to demonstrate that there are some registries supporting hybridized registry/eReferral use cases that require a separate set of codes. Until practices are more standardized regarding these two code systems, implementers are cautioned that these code systems and value sets still may change. Implementers are encouraged to provide feedback on the value sets and code systems they are expecting to utilize." /> </element> <element id="Practitioner.qualification.code.coding"> <path value="Practitioner.qualification.code.coding" /> <slicing> <discriminator> <type value="value" /> <path value="system" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Practitioner.qualification.code.coding.system"> <path value="Practitioner.qualification.code.coding.system" /> <min value="1" /> </element> <element id="Practitioner.qualification.code.coding.code"> <path value="Practitioner.qualification.code.coding.code" /> <min value="1" /> </element> <element id="Practitioner.qualification.code.coding:Registry"> <path value="Practitioner.qualification.code.coding" /> <sliceName value="Registry" /> </element> <element id="Practitioner.qualification.code.coding:Registry.system"> <path value="Practitioner.qualification.code.coding.system" /> <short value="QualifiedRoleType" /> <definition value="A code system for the degree or educational rank that the credential specifies. May also apply to an Expertise type." /> <min value="1" /> <patternUri value="https://fhir.infoway-inforoute.ca/CodeSystem/scpqual" /> </element> <element id="Practitioner.qualification.code.coding:eReferral"> <path value="Practitioner.qualification.code.coding" /> <sliceName value="eReferral" /> <comment value="Some registries may be used to support electronic referral use cases. A separate code system for practitioner qualification codes has been identified as in use by at least one Canadian registry supporting the hybridized use case." /> </element> <element id="Practitioner.qualification.code.coding:eReferral.system"> <path value="Practitioner.qualification.code.coding.system" /> <short value="HealthcareProviderRoleType" /> <definition value="A role type that is used to categorize an entity that delivers health care in an expected and professional manner to an entity in need of health care services." /> <min value="1" /> <patternUri value="https://fhir.infoway-inforoute.ca/CodeSystem/scptype" /> </element> </differential> </StructureDefinition>