{ "resourceType": "StructureDefinition", "id": "consentdirective", "text": { "status": "generated", "div": "

The narrative has been removed to reduce the size of the distribution of the Hl7.Fhir.Specification library

" }, "url": "http://hl7.org/fhir/StructureDefinition/consentdirective", "name": "Consent Directive", "status": "draft", "publisher": "Health Level Seven International (Community Based Collaborative Care)", "contact": [ { "telecom": [ { "system": "other", "value": "http://hl7.org/special/committees/Security" } ] } ], "description": "Consent Directive", "fhirVersion": "3.0.0", "mapping": [ { "identity": "v2", "uri": "http://hl7.org/v2", "name": "HL7 v2" } ], "kind": "resource", "abstract": false, "type": "Contract", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Contract", "derivation": "constraint", "snapshot": { "element": [ { "id": "Contract", "path": "Contract", "short": "Consent Directive", "definition": "A record of a healthcare consumer’s privacy policy, which is in accordance with governing jurisdictional and organization privacy policies that grant or withhold consent: • To one or more identified entities in a defined role • To perform one or more operations (e.g. collect, access, use, disclose, amend, or delete) • On an instance or type of individually identifiable health information [IIHI] • For a purpose such as treatment, payment, operations, research, public health, quality measures, health status evaluation by third parties, or marketing • Under certain conditions, e.g. when unconscious • For specified time period, e.g. effective and expiration dates • In certain context, e.g. in an emergency  A consent directive is an instance of governing jurisdictional and organization privacy policies, which may or may not be backed up by a signed document (paper or electronic). [HITSP TP30].", "min": 0, "max": "*", "base": { "path": "Resource", "min": 0, "max": "*" }, "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-1", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative", "expression": "contained.text.empty()", "xpath": "not(parent::f:contained and f:text)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-3", "severity": "error", "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource", "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()", "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" } ], "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "workflow", "map": "Event" }, { "identity": "rim", "map": "FinancialContract" }, { "identity": "w5", "map": "financial.other" } ] }, { "id": "Contract.id", "path": "Contract.id", "short": "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.", "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.", "min": 0, "max": "1", "base": { "path": "Resource.id", "min": 0, "max": "1" }, "type": [ { "code": "id" } ], "isSummary": true }, { "id": "Contract.meta", "path": "Contract.meta", "short": "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.", "min": 0, "max": "1", "base": { "path": "Resource.meta", "min": 0, "max": "1" }, "type": [ { "code": "Meta" } ], "isSummary": true }, { "id": "Contract.implicitRules", "path": "Contract.implicitRules", "short": "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.", "comment": "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.", "min": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "isModifier": true, "isSummary": true }, { "id": "Contract.language", "path": "Contract.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "comment": "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).", "min": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueReference": { "reference": "http://hl7.org/fhir/ValueSet/all-languages" } }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Language" } ], "strength": "extensible", "description": "A human language.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/languages" } } }, { "id": "Contract.text", "path": "Contract.text", "short": "Text summary of the resource, for human interpretation", "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.", "comment": "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.", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 0, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "1" }, "type": [ { "code": "Narrative" } ], "condition": [ "dom-1" ], "mapping": [ { "identity": "rim", "map": "Act.text?" } ] }, { "id": "Contract.contained", "path": "Contract.contained", "short": "Contained, inline 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.", "comment": "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.", "alias": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Contract.extension", "path": "Contract.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "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.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "Contract.modifierExtension", "path": "Contract.modifierExtension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Extensions that cannot be ignored", "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.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "Contract.identifier", "path": "Contract.identifier", "label": "ConsentDirective-identifier", "short": "Consent Directive identifier", "definition": "Unique identifier for this Consent Directive.", "min": 0, "max": "1", "base": { "path": "Contract.identifier", "min": 0, "max": "1" }, "type": [ { "code": "Identifier" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.identifier" }, { "identity": "rim", "map": "FinancialContract id" } ] }, { "id": "Contract.status", "path": "Contract.status", "short": "amended | appended | cancelled | disputed | entered-in-error | executable | executed | negotiable | offered | policy | rejected | renewed | revoked | resolved | terminated", "definition": "The status of the resource instance.", "comment": "This element is labeled as a modifier because the status contains codes that mark the contract as not currently valid or active.", "min": 0, "max": "1", "base": { "path": "Contract.status", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "isModifier": true, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ContractStatus" } ], "strength": "required", "description": "A code specifying the state of the resource instance.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-status" } }, "mapping": [ { "identity": "workflow", "map": "Event.status" } ] }, { "id": "Contract.issued", "path": "Contract.issued", "label": "ConsentDirective-issued", "short": "When this Consent Directive was issued", "definition": "Date and time when this Consent Directive was executed and became effective.", "min": 0, "max": "1", "base": { "path": "Contract.issued", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.occurrence" }, { "identity": "rim", "map": "Act.availabilityTime. Definition: A time expression specifying when an Observation, Procedure, or other Act occurs, or, depending on the mood, is supposed to occur, scheduled to occur, etc. The activityTime includes the times of component actions (such as preparation and clean-up). For Procedures and SubstanceAdministrations, the activityTime can provide a needed administrative function by providing a more inclusive time to be anticipated in scheduling. UsageNotes:The activityTime is primarily of administrative rather than clinical use. The clinically relevant time is the effectiveTime. When an observation of a prior symptom is made, the activityTime describes the time the observation is made, as opposed to effectiveTime which is the time the symptom is reported to have occurred. Thus the activityTime may be entirely different from the effectiveTime of the same Act. However, even apart from clinical use cases, designers should first consider effectiveTime as the primary relevant time for an Act. ActivityTime indicates when an Act occurs, not when it is recorded." }, { "identity": "w5", "map": "when.done" }, { "identity": "rim", "map": "FinancialContract effectiveTime" } ] }, { "id": "Contract.applies", "path": "Contract.applies", "label": "ConsentDirective-applies", "short": "Effective time", "definition": "Time period during which this Consent Directive is in effect.", "min": 0, "max": "1", "base": { "path": "Contract.applies", "min": 0, "max": "1" }, "type": [ { "code": "Period" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "Act.effectiveTime Definition: The clinically or operationally relevant time of an act, exclusive of administrative activity." }, { "identity": "rim", "map": "FinancialContract activityTime" } ] }, { "id": "Contract.subject", "path": "Contract.subject", "short": "Contract Target Entity", "definition": "The target entity impacted by or of interest to parties to the agreement.", "comment": "The Contract.subject is an entity that has some role with respect to the Contract.topic and Contract.topic.term, which is of focal interest to the parties to the contract and likely impacted in a significant way by the Contract.action/Contract.action.reason and the Contract.term.action/Contract.action.reason. \rIn many cases, the Contract.subject is a Contract.signer if the subject is an adult; has a legal interest in the contract; and incompetent to participate in the contract agreement.", "requirements": "The Contract.subject is an entity that has some role with respect to the Contract.topic and Contract.topic.term, which is of focal interest to the parties to the contract and likely impacted in a significant way by the Contract.action/Contract.action.reason and the Contract.term.action/Contract.action.reason. In many cases, the Contract.subject is a Contract.signer if the subject is an adult; has a legal interest in the contract; and incompetent to participate in the contract agreement.", "alias": [ "Patient" ], "min": 0, "max": "*", "base": { "path": "Contract.subject", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.subject" }, { "identity": "rim", "map": "RoleClass, RoleCode" }, { "identity": "w5", "map": "who.actor" } ] }, { "id": "Contract.topic", "path": "Contract.topic", "label": "ConsentDirective-topic", "short": "The Patient is the topic of this Consent Directive", "definition": "Patient information and actions taken on that information that are governed by this Consent Directive.", "comment": "The Contract.topic may be an application for or offer of a policy or service (e.g., uri to a consent directive form or a health insurance policy), which becomes the Contract once accepted by both the grantor and grantee. \rThe Contract Resource may function simply as the computable representation of the executed contract, which may be the attached to the Contract Resource as the “binding” or as the “friendly” electronic form. For example, a Contract Resource may be automatically populated with the values expressed in a related QuestionnaireResponse. \rHowever, the Contract Resource may be considered the legally binding contract if it is the only “executed” form of this contract, and includes the signatures as *The Contract Resource may function as the computable representation of an application or offer in a pre-executed Contract if the grantor has not entered any values. In this case, it is populated with values in a “legal” form of the application or offer or by the values in an associated Questionnaire. If the grantor has filled in the legal form or the associated Questionnaire Response, then these values are used to populate a pre-executed Contract Resource.\rIf the Contract.topic is considered an application or offer, then the policy is often required to be attached as the “legal” basis for the application to ensure “informed consent” to the contract, and that any discrepancy between the application and the policy are interpreted against the policy. Implementers should check organizational and jurisdictional policies to determine the relationship among multiple representations of a contract pre- and post-execution.", "requirements": "In the context of a contract, the topic is the matter under consideration in regards to which specific rights, privileges, obligations, restrictions, and prohibitions are binding on any grantor and grantee parties upon the execution of the contract. \rGiven the wide range of contract topics, implementers need to be cognizant of the business use case for which they are designing a FHIR Contract, and narrowly specify the topic being represented with respect to the Contract.type and any specializing Contract.subtype. \rThe same topic, e.g., an asset such as a good or service, such as a real property, medical supply, insurance, information, a procedure or employment, or a manner of conduct, such adherence to a privacy, trust, or security policy, may be the topic of multiple types of contracts. \rOne way to determine the Contract.topic is to answer the question: “What is the object of negotiation?”\rAnswer: The Contract.topic, which may be described with more detail in the [0..*]Contract.valuedItem @ [0..1] Contract.valuedItem.entity[x] Definition: Specific type of Contract Valued Item that may be priced. CodeableConcept|Reference(Any)\rContract.topic is “the what” that a grantor is exchanging with a grantee in return for some benefit. \rContract.topic is “the what” to which any Contract.action is being applied for any stipulated Contract.action.reason. \rAContract.topic is “the what” governed by the execution of the contract to which any party’s rights, privileges, obligations, restrictions, and prohibitions apply.", "min": 1, "max": "1", "base": { "path": "Contract.topic", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" } ], "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.context" }, { "identity": "rim", "map": "Includes many ActClass, ActCode, RoleClass, RoleCode, EntityClass, EntityCode, ParticipationType codes from HL7 concept domains and code systems. For example, RoleCode: HLD (held entity) Description: Entity that is currently in the possession of a holder (scoper), who holds, or uses it, usually based on some agreement with the owner. MANU (manufactured product) Description: Scoped by the manufacturer. OWN (owned entity) Description: An Entity (player) for which someone (scoper) is granted by law the right to call the material (player) his own. This entitles the scoper to make decisions about the disposition of that material. WRTE (warranted product) Description:\rA role a product plays when a guarantee is given to the purchaser by the seller (scoping entity) stating that the product is reliable and free from known defects and that the seller will repair or replace defective parts within a given time limit and under certain conditions." }, { "identity": "rim", "map": "Role" } ] }, { "id": "Contract.authority", "path": "Contract.authority", "label": "ConsentDirective-authority", "short": "Authority under which this Consent Directive has standing", "definition": "A formally recognized grouping of people, principals, organizations, or jurisdictions with legal standing to promulgate, administer, and enforce privacy policies and applicable Consent Directives.", "min": 0, "max": "*", "base": { "path": "Contract.authority", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" } ], "mapping": [ { "identity": "rim", "map": "Organization Role. CONCEPT DOMAIN: OrganizationEntityType Description: Further classifies entities of EntityClass ORG." }, { "identity": "rim", "map": "Role Scoper" } ] }, { "id": "Contract.domain", "path": "Contract.domain", "label": "ConsentDirective-domain", "short": "Domain in which this Consent Directive applies", "definition": "Recognized governance framework or system operating with a circumscribed scope in accordance with specified principles, policies, processes or procedures for managing rights, actions, or behaviors of parties or principals relative to privacy protection and control of the collection, access, use and disclosure of resources.", "alias": [ "scope of governance jurisdiction" ], "min": 0, "max": "*", "base": { "path": "Contract.domain", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location" } ], "mapping": [ { "identity": "rim", "map": "TERR (territory of authority) Description: Relates a place entity (player) as the region over which the scoper (typically an Organization) has certain authority (jurisdiction). For example, the Calgary Regional Health Authority (scoper) has authority over the territory \"Region 4 of Alberta\" (player) in matters of health.\rEntity Class = Place? A physical place or site with its containing structure. May be natural or man-made. The geographic position of a place may or may not be constant.\rCONCEPT DOMAIN: TerritoryEntityType Description: A territorial entity that may be cited as the body over which an agency exercises jurisdiction, or which defines a sphere in which a party has a particular responsibility. CONCEPT DOMAIN: OrganizationEntityType\rDescription: Further classifies entities of EntityClass ORG." } ] }, { "id": "Contract.type", "path": "Contract.type", "label": "ConsentDirective-type", "short": "Consent Directive Type", "definition": "Specific type of patient privacy Consent Directive reflecting the range of patient discretion over granting of rights to patient information and actions that may be taken on that information; e.g. Opt-in, opt-out, Share All (such as authorization to disclose to payer for payment purposes or benefit eligibility), Share Partial(such as Title 38 Section 7332 and 42 CFR Part 2), Implied Consent, such as a HIPAA Notice of Privacy Practices.", "min": 1, "max": "1", "base": { "path": "Contract.type", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ContractType" } ], "strength": "example", "description": "List of overall contract codes.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-type" } }, "mapping": [ { "identity": "rim", "map": "Maps to multiple ActClass and ActCode Concept Domains and Code Systems such as the following: In the ActClass Concept Domain: ActClassPolicy. In the ActCode Concept Domain: ActContractType, which generalizes ActFinancialContractType, ActCoverageType, ActBillingArrangementType. ActConsentType, which generalizes ActDataConsentType; ActFinancialParticipationConsentType; ActInformationAccessCode; AdvanceBeneficiaryNoticeType. ActPolicyType, which generalizes: ActPrivacyPolicyType, ActSensitivityPrivacyPolicyType, ActSecurityPolicyType. In the ActClass Code System: CNTRCT (contract) Description: An agreement of obligation between two or more parties that is subject to contractual law and enforcement, lwhich generalizes FCNTRCT (financial contract) and COV (coverage). POLICY (policy) - Description: A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by one party on: The activity of another party; the behavior of another party; or the manner in which an act is executed. LEAF CONCEPTS: JURISPOL (jurisdictional policy) Description:A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by a jurisdiction on: The activity of another party; the behavior of another party; or the manner in which an act is executed.Examples:A jurisdictional mandate regarding the prescribing and dispensing of a particular medication. A jurisdictional privacy or security regulation dictating the manner in which personal health information is disclosed. A jurisdictional requirement that certain services or health conditions are reported to a monitoring program, e.g., immunizations, methadone treatment, or cancer registries.ORGPOL (organizational policy)Examples:A clinical or research protocols imposed by a payer, a malpractice insurer, or an institution to which a provider must adhere. A mandate imposed by a denominational institution for a provider to provide or withhold certain information from the patient about treatment options.SCOPOL (scope of practice policy)Description:An ethical or clinical obligation, requirement, rule, or expectation imposed or strongly encouraged by organizations that oversee particular clinical domains or provider certification which define the boundaries within which a provider may practice and which may have legal basis or ramifications.Examples:An ethical obligation for a provider to fully inform a patient about all treatment options. An ethical obligation for a provider not to disclose personal health information that meets certain criteria, e.g., where disclosure might result in harm to the patient or another person. The set of health care services which a provider is credentialed or privileged to provide. STDPOL (standard of practice policy) Examples:A payer may require a prescribing provider to adhere to formulary guidelines. An institution may adopt clinical guidelines and protocols and implement these within its electronic health record and decision support systems. CONS (consent)Description: The Consent class represents informed consents and all similar medico-legal transactions between the patient (or his legal guardian) and the provider. Examples are informed consent for surgical procedures, informed consent for clinical trials, advanced beneficiary notice, against medical advice decline from service, release of information agreement, etc. The details of consents vary. Often an institution has a number of different consent forms for various purposes, including reminding the physician about the topics to mention. Such forms also include patient education material. In electronic medical record communication, consents thus are information-generating acts on their own and need to be managed similar to medical activities. Thus, Consent is modeled as a special class of Act. The \"signatures\" to the consent document are represented electronically through Participation instances to the consent object. Typically an informed consent has Participation.typeCode of \"performer\", the healthcare provider informing the patient, and \"consenter\", the patient or legal guardian. Some consent may associate a witness or a notary public (e.g., living wills, advanced directives). In consents where a healthcare provider is not required (e.g. living will), the performer may be the patient himself or a notary public." }, { "identity": "rim", "map": "CNTRCT" } ] }, { "id": "Contract.subType", "path": "Contract.subType", "label": "ConsentDirective-subType", "short": "Consent Directive Subtype", "definition": "A specialized type of an overarching or more general Consent Directive, such as a patient's right to opt-out of a Patient Directory under HIPAA or a multiparty 42 CFR Part 2 consent used in a health information exchange context by a Qualified Service Organization.", "min": 0, "max": "*", "base": { "path": "Contract.subType", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ContractSubtype" } ], "strength": "example", "description": "Detailed codes within the above.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-subtype" } }, "mapping": [ { "identity": "rim", "map": "Examples of Contract or Policy subtypes in ActCodes:_ActCoverageTypeCode Definition: Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties. Generalizes: _ActInsurancePolicyCode; _ActInsuranceTypeCode; ActProgramTypeCode. _ActPolicyType Description:Types of policies that further specify the ActClassPolicy value set. Generalizes: _ActPrivacyPolicy; _ActPrivacyLaw; _InformationSensitivityPolicy; ActTrustPolicyType; SecurityPolicy. _ActInvoiceAdjudicationPaymentGroupCode Description: Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc., e.g. RECOV (recovery) Description: Retroactive adjustment such as fee rate adjustment due to contract negotiations." }, { "identity": "rim", "map": "e.g. RECOV" } ] }, { "id": "Contract.action", "path": "Contract.action", "label": "ConsentDirective-action", "short": "Consent Directive Action", "definition": "Action stipulated by this Consent Directive.", "min": 0, "max": "*", "base": { "path": "Contract.action", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ContractAction" } ], "strength": "example", "description": "Detailed codes for the contract action.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-action" } }, "mapping": [ { "identity": "rim", "map": "Maps to multiple ActClass and ActCode Concept Domains and Code Systems." }, { "identity": "rim", "map": "e.g. JURISPOL" } ] }, { "id": "Contract.actionReason", "path": "Contract.actionReason", "label": "ConsentDirective-actionReason", "short": "Consent Directive Action Reason", "definition": "Reason for action stipulated by this Consent Directive.", "min": 0, "max": "*", "base": { "path": "Contract.actionReason", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ContractActionReason" } ], "strength": "example", "description": "Detailed codes for the contract action reason.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-PurposeOfUse" } }, "mapping": [ { "identity": "rim", "map": "Examples from ActReason Concept Domains: ActCoverageReason Description:Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties. ActInformationPrivacyReason Description: The rationale or purpose for an act relating to the management of personal information, such as disclosing personal tax information for the purpose of complying with a court order. ClinicalResearchObservationReason Definition: Specifies the reason that a test was performed or observation collected in a clinical research study. SafetyInvestigationReportReasonType Description: Possible reasons generating a report providing information developed during the investigation of an adverse event or a product problem. ControlActReason Description: Indicates the motivation, cause or rationale of an Act which results in a trigger event. NonPerformanceReasonCode Description: The reason the action was not performed, e.g. why the medication was not taken. If an action was not performed, it is often clinically important to know why the action was not taken. RefusalReasonCode Description: Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.\r\r\r\r\r\r\r\rExamples from HL7 ActReason Code System: QUALIMP (quality improvement) Description:Operational activities conducted for the purposes of improving the quality of an activity, product, or service. _PatientProfileQueryReasonCode Description: A collection of concepts identifying why the patient's profile is being queried. _ActInformationManagementReason Description:The rationale or purpose for an act relating to information management, such as archiving information for the purpose of complying with an enterprise data retention policy. _ActInvalidReason (ActInvalidReason) Description: Types of reasons why a substance is invalid for use. _NonPerformanceReasonCode Description: The reason the action wasn't performed, e.g. why the medication was not taken. If an action wasn\"t performed, it is often clinically important to know why the action wasn\"t taken." }, { "identity": "rim", "map": "e.g. QUALIMP" } ] }, { "id": "Contract.decisionType", "path": "Contract.decisionType", "short": "Decision by Grantor", "definition": "The type of decision made by a grantor with respect to an offer made by a grantee.", "min": 0, "max": "1", "base": { "path": "Contract.decisionType", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ContractDecisionType" } ], "strength": "extensible", "description": "The type of decision made by a grantor with respect to an offer made by a grantee.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-ActConsentDirective" } }, "mapping": [ { "identity": "rim", "map": "ActCode: _ActConsentDirective [abstract term] Description: Specifies the type of agreement between one or more grantor and grantee in which rights and obligations related to one or more shared items of interest are allocated. Usage Note: Such agreements may be considered \"consent directives\" or \"contracts\" depending on the context, and are considered closely related or synonymous from a legal perspective." } ] }, { "id": "Contract.contentDerivative", "path": "Contract.contentDerivative", "short": "Content derived from the basal information", "definition": "The minimal content derived from the basal information source at a specific stage in its lifecycle.", "min": 0, "max": "1", "base": { "path": "Contract.contentDerivative", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ContractContentDerivative" } ], "strength": "example", "description": "This is an example set of Content Derivative type codes, which represent the minimal content derived from the basal information source.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-content-derivative" } }, "mapping": [ { "identity": "rim", "map": "Maps partially to several v3 codes: ActClass: REG (registration) Description: Represents the act of maintaining information about the registration of its associated registered subject. The subject can be either an Act or a Role, and includes subjects such as lab exam definitions, drug protocol definitions, prescriptions, persons, patients, practitioners, and equipment.\rThe registration may have a unique identifier - separate from the unique identification of the subject - as well as a core set of related participations and act relationships that characterize the registration event and aid in the disposition of the subject information by a receiving system. Observation: VERIF (Verification) Description: An act which describes the process whereby a 'verifying party' validates either the existence of the Role attested to by some Credential or the actual Vetting act and its details. TRFR (transfer) Description: The act of transferring information without the intent of imparting understanding about a topic to the subject that is the recipient or holder of the transferred information where the participation association must be RCV or HLD. _ActDetectedIssueManagementCode [abstract term] Description: Codes dealing with the management of Detected Issue observations. _ActInformationAccessContextCode [abstract term] Description: Concepts conveying the context in which authorization given under jurisdictional law, by organizational policy, or by a patient consent directive permits the collection, access, use or disclosure of specified patient health information. _ActListCode [abstract term]vDescription: Provides codes associated with ActClass value of LIST (working list). RefusalReasonCode [abstract term] Description:\rDescription: Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action." } ] }, { "id": "Contract.securityLabel", "path": "Contract.securityLabel", "short": "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.", "min": 0, "max": "*", "base": { "path": "Contract.securityLabel", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "SecurityLabels" } ], "strength": "extensible", "description": "Security Labels from the Healthcare Privacy and Security Classification System.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/security-labels" } }, "mapping": [ { "identity": "rim", "map": "ActCode ObservationType:SECOBS [abstract term]\rDescription: An observation identifying security metadata about an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security metadata are used to name security labels. \rRationale: According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING, Security label matching compares the initiator's clearance to the target's security label. All of the following must be true for authorization to be granted:\rThe security policy identifiers shall be identical. The classification level of the initiator shall be greater than or equal to that of the target (that is, there shall be at least one value in the classification list of the clearance greater than or equal to the classification of the target), and For each security category in the target label, there shall be a security category of the same type in the initiator's clearance and the initiator's classification level shall dominate that of the target. Examples: SecurityObservationType security label fields include: Confidentiality classification; Compartment category; Sensitivity category\rSecurity mechanisms used to ensure data integrity or to perform authorized data transformation Indicators of an IT resource completeness, veracity, reliability, trustworthiness, or provenance. Usage Note: SecurityObservationType codes designate security label field types, which are valued with an applicable SecurityObservationValue code as the \"security label tag\". _SecurityObservationValue [abstract term] Description: Observation values used to indicate security observation metadata." } ] }, { "id": "Contract.agent", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Agent" } ], "path": "Contract.agent", "short": "Entity being ascribed responsibility", "definition": "An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place.", "comment": "Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa.\rFor example, in cases of actions initiated by one user for other users, or in events that involve more than one user, hardware device, software, or system process. However, only one user may be the initiator/requestor for the event.", "requirements": "An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility.", "min": 0, "max": "*", "base": { "path": "Contract.agent", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.signer", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Signatory" } ], "path": "Contract.signer", "label": "ConsentDirective-signer", "short": "Consent Directive Signer", "definition": "Party signing this Consent Directive.", "comment": "Signers who are principal parties to the contract are bound by the Contract.activity related to the Contract.topic, and the Contract.term(s), which either extend or restrict the overall action on the topic by, for example, stipulating specific policies or obligations constraining actions, action reason, or agents with respect to some or all of the topic.\rFor example, specifying how policies or obligations shall constrain actions and action reasons permitted or denied on all or a subset of the Contract.topic (e.g., all or a portion of property being transferred by the contract), agents (e.g., who can resell, assign interests, or alter the property being transferred by the contract), actions, and action reasons; or with respect to Contract.terms, stipulating, extending, or limiting the Contract.period of applicability or valuation of items under consideration.", "requirements": "The Contract.signer applies a signature to the Contract.binding referenced resource, which is the documentation that is the legal \"source of truth\". The Contract.signer may delegate, such as a legally recognized personal representative, or have a delegate assigned e.g., by a court of law, to actually sign the Contract, such as a trustee in the case of incompetence.", "min": 0, "max": "*", "base": { "path": "Contract.signer", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.valuedItem", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "ValuedItem" } ], "path": "Contract.valuedItem", "label": "ConsentDirective-valuedItem", "short": "Contract Valued Item", "definition": "Contract Valued Item List.", "min": 0, "max": "0", "base": { "path": "Contract.valuedItem", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedItem classCode INVE" } ] }, { "id": "Contract.term", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Term" } ], "path": "Contract.term", "label": "ConsentDirective-term", "short": "Consent Directive Term List", "definition": "One or more Consent DirectiveProvisions, which may be related and conveyed as a group, and may contain nested groups.", "min": 0, "max": "*", "base": { "path": "Contract.term", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "rim", "map": "RIM mechanism for grouping or nesting rules, which are likely Acts and Observations." } ] }, { "id": "Contract.binding[x]", "path": "Contract.binding[x]", "label": "ConsentDirective-binding[x]", "short": "Binding Consent Directive", "definition": "Legally binding onsent Directive Provision. This is the signed and legally recognized representation of the Consent Directive. that is considered the \"source of truth\", which would be the basis for legal action related to enforcement of the onsent Directive Provision.", "min": 1, "max": "1", "base": { "path": "Contract.binding[x]", "min": 0, "max": "1" }, "type": [ { "code": "Attachment" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Composition" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DocumentReference" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" } ], "mapping": [ { "identity": "rim", "map": "DocumentCompletion code system AU (authenticated) Description: A completion status in which a document has been signed manually or electronically by one or more individuals who attest to its accuracy. No explicit determination is made that the assigned individual has performed the authentication. While the standard allows multiple instances of authentication, it would be typical to have a single instance of authentication, usually by the assigned individual." } ] }, { "id": "Contract.friendly", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "FriendlyLanguage" } ], "path": "Contract.friendly", "label": "ConsentDirective-friendly", "short": "Consent Directive Friendly Language", "definition": "The \"patient friendly language\" versionof the Consent Directive in whole or in parts. \"Patient friendly language\" means the representation of the Consent Directive and Consent Directive Provisions in a manner that is readily accessible and understandable by a layperson in accordance with best practices for communication styles that ensure that those agreeing to or signing the Consent Directive understand the roles, actions, obligations, responsibilities, and implication of the agreement.", "min": 0, "max": "*", "base": { "path": "Contract.friendly", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.legal", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "LegalLanguage" } ], "path": "Contract.legal", "label": "ConsentDirective-legal", "short": "Consent Directive Legal Language", "definition": "List of Legal expressions or representations of this Consent Directive.", "min": 0, "max": "*", "base": { "path": "Contract.legal", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.rule", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "ComputableLanguage" } ], "path": "Contract.rule", "label": "ConsentDirective-rule", "short": "Computable Consent Directive Language", "definition": "List of Computable Policy Rule Language Representations of this Consent Directive.", "min": 0, "max": "*", "base": { "path": "Contract.rule", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.actor", "path": "Contract.actor", "label": "ConsentDirective-actor", "short": "Consent Directive Actor", "definition": "List of Consent Directive actors.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ] } ] }, "differential": { "element": [ { "id": "Contract", "path": "Contract", "short": "Consent Directive", "definition": "A record of a healthcare consumer’s privacy policy, which is in accordance with governing jurisdictional and organization privacy policies that grant or withhold consent: • To one or more identified entities in a defined role • To perform one or more operations (e.g. collect, access, use, disclose, amend, or delete) • On an instance or type of individually identifiable health information [IIHI] • For a purpose such as treatment, payment, operations, research, public health, quality measures, health status evaluation by third parties, or marketing • Under certain conditions, e.g. when unconscious • For specified time period, e.g. effective and expiration dates • In certain context, e.g. in an emergency  A consent directive is an instance of governing jurisdictional and organization privacy policies, which may or may not be backed up by a signed document (paper or electronic). [HITSP TP30].", "min": 0, "max": "*", "mapping": [ { "identity": "rim", "map": "FinancialContract" }, { "identity": "w5", "map": "financial.other" } ] }, { "id": "Contract.actor", "path": "Contract.actor", "label": "ConsentDirective-actor", "short": "Consent Directive Actor", "definition": "List of Consent Directive actors.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.actor.entity", "path": "Contract.actor.entity", "label": "ConsentDirective-actor-entity", "short": "Consent Directive Actor Type", "definition": "Who or what actors are assigned roles in this Consent Directive.", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Contract" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Substance" } ] }, { "id": "Contract.actor.role", "path": "Contract.actor.role", "label": "ConsentDirective-actor-role", "short": "Consent Directive Actor Role", "definition": "Role type of actors assigned roles in this Consent Directive.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "Detailed codes for the contract actor role.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-actorrole" } } }, { "id": "Contract.identifier", "path": "Contract.identifier", "label": "ConsentDirective-identifier", "short": "Consent Directive identifier", "definition": "Unique identifier for this Consent Directive.", "min": 0, "max": "1", "type": [ { "code": "Identifier" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "FinancialContract id" } ] }, { "id": "Contract.issued", "path": "Contract.issued", "label": "ConsentDirective-issued", "short": "When this Consent Directive was issued", "definition": "Date and time when this Consent Directive was executed and became effective.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "FinancialContract effectiveTime" } ] }, { "id": "Contract.applies", "path": "Contract.applies", "label": "ConsentDirective-applies", "short": "Effective time", "definition": "Time period during which this Consent Directive is in effect.", "min": 0, "max": "1", "type": [ { "code": "Period" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "FinancialContract activityTime" } ] }, { "id": "Contract.topic", "path": "Contract.topic", "label": "ConsentDirective-topic", "short": "The Patient is the topic of this Consent Directive", "definition": "Patient information and actions taken on that information that are governed by this Consent Directive.", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "Role" } ] }, { "id": "Contract.authority", "path": "Contract.authority", "label": "ConsentDirective-authority", "short": "Authority under which this Consent Directive has standing", "definition": "A formally recognized grouping of people, principals, organizations, or jurisdictions with legal standing to promulgate, administer, and enforce privacy policies and applicable Consent Directives.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" } ], "mapping": [ { "identity": "rim", "map": "Role Scoper" } ] }, { "id": "Contract.domain", "path": "Contract.domain", "label": "ConsentDirective-domain", "short": "Domain in which this Consent Directive applies", "definition": "Recognized governance framework or system operating with a circumscribed scope in accordance with specified principles, policies, processes or procedures for managing rights, actions, or behaviors of parties or principals relative to privacy protection and control of the collection, access, use and disclosure of resources.", "alias": [ "scope of governance jurisdiction" ], "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location" } ] }, { "id": "Contract.type", "path": "Contract.type", "label": "ConsentDirective-type", "short": "Consent Directive Type", "definition": "Specific type of patient privacy Consent Directive reflecting the range of patient discretion over granting of rights to patient information and actions that may be taken on that information; e.g. Opt-in, opt-out, Share All (such as authorization to disclose to payer for payment purposes or benefit eligibility), Share Partial(such as Title 38 Section 7332 and 42 CFR Part 2), Implied Consent, such as a HIPAA Notice of Privacy Practices.", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "strength": "example", "description": "List of overall contract codes.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-type" } }, "mapping": [ { "identity": "rim", "map": "CNTRCT" } ] }, { "id": "Contract.type.coding.code", "path": "Contract.type.coding.code", "short": "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.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "fixedCode": "57016-8", "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1" }, { "identity": "rim", "map": "./code" }, { "identity": "orim", "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" } ] }, { "id": "Contract.type.coding.system", "path": "Contract.type.coding.system", "short": "Identity of the terminology system", "definition": "The identification of the code system that defines the meaning of the symbol in the code.", "comment": "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.", "requirements": "Need to be unambiguous about the source of the definition of the symbol.", "min": 0, "max": "1", "type": [ { "code": "uri" } ], "fixedUri": "http://loinc.org", "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.3" }, { "identity": "rim", "map": "./codeSystem" }, { "identity": "orim", "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" } ] }, { "id": "Contract.subType", "path": "Contract.subType", "label": "ConsentDirective-subType", "short": "Consent Directive Subtype", "definition": "A specialized type of an overarching or more general Consent Directive, such as a patient's right to opt-out of a Patient Directory under HIPAA or a multiparty 42 CFR Part 2 consent used in a health information exchange context by a Qualified Service Organization.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "strength": "example", "description": "Detailed codes within the above.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-subtype" } }, "mapping": [ { "identity": "rim", "map": "e.g. RECOV" } ] }, { "id": "Contract.action", "path": "Contract.action", "label": "ConsentDirective-action", "short": "Consent Directive Action", "definition": "Action stipulated by this Consent Directive.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "Detailed codes for the contract action.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-action" } }, "mapping": [ { "identity": "rim", "map": "e.g. JURISPOL" } ] }, { "id": "Contract.actionReason", "path": "Contract.actionReason", "label": "ConsentDirective-actionReason", "short": "Consent Directive Action Reason", "definition": "Reason for action stipulated by this Consent Directive.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "Detailed codes for the contract action reason.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-PurposeOfUse" } }, "mapping": [ { "identity": "rim", "map": "e.g. QUALIMP" } ] }, { "id": "Contract.signer", "path": "Contract.signer", "label": "ConsentDirective-signer", "short": "Consent Directive Signer", "definition": "Party signing this Consent Directive.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.signer.type", "path": "Contract.signer.type", "label": "ConsentDirective-signer-type", "short": "Consent Directive Signer Type", "definition": "Role of this Consent Directive signer, e.g. patient who is Consent Directive Grantee, the Substitute Decision Maker such as a person with Power of Attorney to whom the patient has granted or delegated rights to execute a Consent Directive on the patient's behalf, a notary public or witness.", "min": 1, "max": "1", "type": [ { "code": "Coding" } ], "binding": { "strength": "preferred", "description": "List of parties who may be signing.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-signer-type" } } }, { "id": "Contract.signer.party", "path": "Contract.signer.party", "label": "ConsentDirective-signer-party", "short": "Consent Directive Signatory party", "definition": "Party which is a signatory to this Consent Directive.", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson" } ] }, { "id": "Contract.signer.signature", "path": "Contract.signer.signature", "label": "ConsentDirective-signer-signature", "short": "Consent Directive Documentation Signature", "definition": "Legally binding Consent Directive DSIG signature contents in Base64.", "min": 1, "max": "1", "type": [ { "code": "string" } ] }, { "id": "Contract.valuedItem", "path": "Contract.valuedItem", "label": "ConsentDirective-valuedItem", "short": "Contract Valued Item", "definition": "Contract Valued Item List.", "min": 0, "max": "0", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedItem classCode INVE" } ] }, { "id": "Contract.valuedItem.entity[x]", "path": "Contract.valuedItem.entity[x]", "label": "ConsentDirective-valuedItem-entity[x]", "short": "Contract Valued Item Type", "definition": "Specific type of Contract Valued Item that may be priced.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedItem code" } ] }, { "id": "Contract.valuedItem.identifier", "path": "Contract.valuedItem.identifier", "label": "ConsentDirective-valuedItem-identifier", "short": "Contract Valued Item Identifier", "definition": "Identifies a Contract Valued Item instance.", "min": 0, "max": "1", "type": [ { "code": "Identifier" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedItem id" } ] }, { "id": "Contract.valuedItem.effectiveTime", "path": "Contract.valuedItem.effectiveTime", "label": "ConsentDirective-valuedItem-effectiveTime", "short": "Contract Valued Item Effective Time", "definition": "Indicates the time during which this Contract ValuedItem information is effective.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedItem effectiveTime" } ] }, { "id": "Contract.valuedItem.quantity", "path": "Contract.valuedItem.quantity", "label": "ConsentDirective-valuedItem-quantity", "short": "Count of Contract Valued Items", "definition": "Specifies the units by which the Contract Valued Item is measured or counted, and quantifies the countable or measurable Contract Valued Item instances.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedItem unitQuantity" } ] }, { "id": "Contract.valuedItem.unitPrice", "path": "Contract.valuedItem.unitPrice", "label": "ConsentDirective-valuedItem-unitprice", "short": "Contract Valued Item fee, charge, or cost.", "definition": "A Contract Valued Item unit valuation measure.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/Money" } ], "mapping": [ { "identity": "v2", "map": "F12" } ] }, { "id": "Contract.valuedItem.factor", "path": "Contract.valuedItem.factor", "label": "ConsentDirective-valuedItem-factor", "short": "Contract Valued Item Price Scaling Factor", "definition": "A real number that represents a multiplier used in determining the overall value of the Contract Valued Item delivered. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.", "min": 0, "max": "1", "type": [ { "code": "decimal" } ], "mapping": [ { "identity": "v2", "map": "F13/F14" } ] }, { "id": "Contract.valuedItem.points", "path": "Contract.valuedItem.points", "label": "ConsentDirective-valuedItem-points", "short": "Contract Valued Item Difficulty Scaling Factor", "definition": "An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the Contract Valued Item delivered. The concept of Points allows for assignment of point values for a Contract Valued Item, such that a monetary amount can be assigned to each point.", "min": 0, "max": "1", "type": [ { "code": "decimal" } ], "mapping": [ { "identity": "v2", "map": "F13/F14" } ] }, { "id": "Contract.valuedItem.net", "path": "Contract.valuedItem.net", "label": "ConsentDirective-valuedItem-net", "short": "Total Contract Valued Item Value", "definition": "Expresses the product of the Contract Valued Item unitQuantity and the unitPriceAmt. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/Money" } ], "mapping": [ { "identity": "v2", "map": "F13/F14" } ] }, { "id": "Contract.term", "path": "Contract.term", "label": "ConsentDirective-term", "short": "Consent Directive Term List", "definition": "One or more Consent DirectiveProvisions, which may be related and conveyed as a group, and may contain nested groups.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.term.actor", "path": "Contract.term.actor", "label": "ConsentDirective-term-actor", "short": "Consent Directive Term Actor List", "definition": "List of actors participating in this Consent Directive Provision.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.term.actor.entity", "path": "Contract.term.actor.entity", "label": "ConsentDirective-term-actor-entity", "short": "Consent Directive Term Actor", "definition": "The actor assigned a role in this Consent Directive Provision.", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Contract" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Group" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Substance" } ] }, { "id": "Contract.term.actor.role", "path": "Contract.term.actor.role", "label": "ConsentDirective-term-actor-role", "short": "Consent Directive Term Actor Role", "definition": "Role played by the actor assigned this role in this Consent Directive Provision.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "Detailed codes for the contract actor role.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-actorrole" } } }, { "id": "Contract.term.identifier", "path": "Contract.term.identifier", "label": "ConsentDirective-term-identifier", "short": "Consent Directive Term identifier", "definition": "Unique identifier for this particular Consent Directive Provision.", "min": 0, "max": "1", "type": [ { "code": "Identifier" } ], "isSummary": true }, { "id": "Contract.term.issued", "path": "Contract.term.issued", "label": "ConsentDirective-term-issued", "short": "Consent Directive Term Issue Date Time", "definition": "When this Consent Directive Provision was issued.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "isSummary": true }, { "id": "Contract.term.applies", "path": "Contract.term.applies", "label": "ConsentDirective-term-applies", "short": "Consent Directive Term Effective Time", "definition": "Relevant time or time-period when this Consent Directive Provision is applicable.", "min": 0, "max": "1", "type": [ { "code": "Period" } ], "isSummary": true }, { "id": "Contract.term.type", "path": "Contract.term.type", "label": "ConsentDirective-term-type", "short": "Consent Directive Term Type", "definition": "Type of Consent Directive Provision such as specific requirements, purposes for actions, obligations, prohibitions, e.g. life time maximum benefit.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "Detailed codes for the types of contract provisions.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-term-type" } } }, { "id": "Contract.term.subType", "path": "Contract.term.subType", "label": "ConsentDirective-term-subType", "short": "Consent Directive Term Subtype", "definition": "Subtype of this Consent Directive Provision, e.g. life time maximum payment for a contract term for specific valued item, e.g. disability payment.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "Detailed codes for the subtypes of contract provisions.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-term-subtype" } } }, { "id": "Contract.term.topic", "path": "Contract.term.topic", "label": "ConsentDirective-term-topic", "short": "Topic of this Consent Directive Term", "definition": "Who or what this Consent Directive Provision is about.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource" } ] }, { "id": "Contract.term.action", "path": "Contract.term.action", "label": "ConsentDirective-term-action", "short": "Consent Directive Term Action", "definition": "Action stipulated by this Consent Directive Provision.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "Detailed codes for the contract action.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/contract-action" } } }, { "id": "Contract.term.actionReason", "path": "Contract.term.actionReason", "label": "ConsentDirective-term-actionReason", "short": "Consent Directive Term Action Reason", "definition": "Reason or purpose for the action stipulated by this Consent Directive Provision.", "min": 0, "max": "*", "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "example", "description": "Detailed codes for the contract action reason.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/v3-PurposeOfUse" } } }, { "id": "Contract.term.text", "path": "Contract.term.text", "label": "ConsentDirective-term-text", "short": "Human readable Consent Directive term text", "definition": "Human readable form of this Consent Directive Provision.", "min": 0, "max": "1", "type": [ { "code": "string" } ] }, { "id": "Contract.term.valuedItem", "path": "Contract.term.valuedItem", "label": "ConsentDirective-term-valuedItem", "short": "Contract Term Valued Item", "definition": "Contract Provision Valued Item List.", "min": 0, "max": "0", "type": [ { "code": "BackboneElement" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedUnitItem classCode INVE" } ] }, { "id": "Contract.term.valuedItem.entity[x]", "path": "Contract.term.valuedItem.entity[x]", "label": "ConsentDirective-term-valuedItem-entity[x]", "short": "Contract Term Valued Item Type", "definition": "Specific type of Contract Provision Valued Item that may be priced.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Resource" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedUnitItem code" } ] }, { "id": "Contract.term.valuedItem.identifier", "path": "Contract.term.valuedItem.identifier", "label": "ConsentDirective-term-valuedItem", "short": "Contract Term Valued Item Identifier", "definition": "Identifies a Contract Provision Valued Item instance.", "min": 0, "max": "1", "type": [ { "code": "Identifier" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedUnitItem id" } ] }, { "id": "Contract.term.valuedItem.effectiveTime", "path": "Contract.term.valuedItem.effectiveTime", "label": "ConsentDirective-term-valuedItem-effectiveTime", "short": "Contract Term Valued Item Effective Time", "definition": "Indicates the time during which this Contract Term ValuedItem information is effective.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedUnitItem effectiveTime" } ] }, { "id": "Contract.term.valuedItem.quantity", "path": "Contract.term.valuedItem.quantity", "label": "ConsentDirective-term-valuedItem-quantity", "short": "Contract Term Valued Item Count", "definition": "Specifies the units by which the Contract Provision Valued Item is measured or counted, and quantifies the countable or measurable Contract Term Valued Item instances.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedUnitItem unitQuantity" } ] }, { "id": "Contract.term.valuedItem.unitPrice", "path": "Contract.term.valuedItem.unitPrice", "label": "ConsentDirective-term-valuedItem-unitPrice", "short": "Contract Term Valued Item fee, charge, or cost.", "definition": "A Contract Provision Valued Item unit valuation measure.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/Money" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedUnitItem unitPriceAmt" } ] }, { "id": "Contract.term.valuedItem.factor", "path": "Contract.term.valuedItem.factor", "label": "ConsentDirective-term-valuedItem-factor", "short": "Contract Term Valued Item Price Scaling Factor", "definition": "A real number that represents a multiplier used in determining the overall value of the Contract Provision Valued Item delivered. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.", "min": 0, "max": "1", "type": [ { "code": "decimal" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedUnitItem factorNumber" } ] }, { "id": "Contract.term.valuedItem.points", "path": "Contract.term.valuedItem.points", "label": "ConsentDirective-term-valuedItem-points", "short": "Contract Term Valued Item Difficulty Scaling Factor", "definition": "An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the Contract Provision Valued Item delivered. The concept of Points allows for assignment of point values for a Contract Provision Valued Item, such that a monetary amount can be assigned to each point.", "min": 0, "max": "1", "type": [ { "code": "decimal" } ], "mapping": [ { "identity": "rim", "map": "COCT_RM440000UV09 ValuedUnitItem pointNumber" } ] }, { "id": "Contract.term.valuedItem.net", "path": "Contract.term.valuedItem.net", "label": "ConsentDirective-term-valuedItem-net", "short": "Total Contract Term Valued Item Value", "definition": "Expresses the product of the Contract Provision Valued Item unitQuantity and the unitPriceAmt. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": "http://hl7.org/fhir/StructureDefinition/Money" } ] }, { "id": "Contract.term.group", "path": "Contract.term.group", "label": "ConsentDirective-term-group", "short": "Nested Consent DirectiveTerm Group", "definition": "Nested group of Consent Directive Provision.", "min": 0, "max": "*", "contentReference": "#term" }, { "id": "Contract.binding[x]", "path": "Contract.binding[x]", "label": "ConsentDirective-binding[x]", "short": "Binding Consent Directive", "definition": "Legally binding onsent Directive Provision. This is the signed and legally recognized representation of the Consent Directive. that is considered the \"source of truth\", which would be the basis for legal action related to enforcement of the onsent Directive Provision.", "min": 1, "max": "1", "type": [ { "code": "Attachment" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Composition" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DocumentReference" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" } ] }, { "id": "Contract.friendly", "path": "Contract.friendly", "label": "ConsentDirective-friendly", "short": "Consent Directive Friendly Language", "definition": "The \"patient friendly language\" versionof the Consent Directive in whole or in parts. \"Patient friendly language\" means the representation of the Consent Directive and Consent Directive Provisions in a manner that is readily accessible and understandable by a layperson in accordance with best practices for communication styles that ensure that those agreeing to or signing the Consent Directive understand the roles, actions, obligations, responsibilities, and implication of the agreement.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.friendly.content[x]", "path": "Contract.friendly.content[x]", "label": "ConsentDirective-friendly-content[x]", "short": "Easily comprehended representation of this Consent Directive", "definition": "Human readable rendering of this Consent Directive in a format and representation intended to enhance comprehension and ensure understandability.", "min": 1, "max": "1", "type": [ { "code": "Attachment" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Composition" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DocumentReference" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" } ] }, { "id": "Contract.legal", "path": "Contract.legal", "label": "ConsentDirective-legal", "short": "Consent Directive Legal Language", "definition": "List of Legal expressions or representations of this Consent Directive.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.legal.content[x]", "path": "Contract.legal.content[x]", "label": "ConsentDirective-legal-content[x]", "short": "Consent Directive Legal Text", "definition": "Legal Consent Directive text in human renderable form.", "min": 1, "max": "1", "type": [ { "code": "Attachment" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Composition" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DocumentReference" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" } ] }, { "id": "Contract.rule", "path": "Contract.rule", "label": "ConsentDirective-rule", "short": "Computable Consent Directive Language", "definition": "List of Computable Policy Rule Language Representations of this Consent Directive.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ] }, { "id": "Contract.rule.content[x]", "path": "Contract.rule.content[x]", "label": "ConsentDirective-rule-content[x]", "short": "Computable Consent Directive Rules", "definition": "Computable Consent Directive conveyed using a policy rule language (e.g. XACML, DKAL, SecPal).", "min": 1, "max": "1", "type": [ { "code": "Attachment" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DocumentReference" } ] } ] } }