{
  "resourceType": "StructureDefinition",
  "id": "rr-communication",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2018-09-29T20:27:06.866+00:00"
  },
  "url": "http://hl7.org/fhir/us/ecr/StructureDefinition/rr-communication",
  "name": "rr-communication",
  "title": "Reportability Response Communication",
  "status": "draft",
  "description": "This Reportability Response Communication will be created in response to an electronic Initial Case Report Composition and the sharing of the Reportability Response with clinical care will serve several functions, including to: \n\n- Communicate the reportability status, for the responsible PHA(s)of each condition included in the electronic Initial Case Report (eICR)     \n- Identify who (a PHA or an intermediary) prepared the Reportability Response     \n- Indicate whether the eICR has been sent to one or more PHA(s)     \n- Identify which PHA(s) has/have been sent the eICR     \n- Provide contact information for the responsible PHA(s)     \n- Provide suggested or required clinical follow-up activities from the responsible PHA(s), including any additional reporting needs or infection control activities     \n- Provide access to clinical support resources suggested by the responsible PHA(s) for identified reportable conditions     \n- Confirm eICR receipt and processing     \n\nA Reportability Response will also, when requested, be shared with the responsible PHAs (when they have not constructed it) for their internal use, so they understand what has been shared with clinical care and, and to monitor/audit decision support algorithm effectivesness and implementation. When a condition is considered reportable to more than one PHA, the Reportability Response can be helpful in communicating reporting that has been done to other PHAs.     \n\nThe Reportability Response Communication is also structured to allow:     \n\n- Notification, alerting, routing and queueing in work or message management systems for healthcare personnel     \n- Dynamic and static URIs for supplemental data collection and the provision of information resources",
  "fhirVersion": "3.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Communication",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Communication",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Communication",
        "path": "Communication",
        "short": "Reportability Response Communication",
        "definition": "This Reportability Response Communication will be created in response to an electronic Initial Case Report Composition and the sharing of the Reportability Response with clinical care will serve several functions, including to: \n\n- Communicate the reportability status, for the responsible PHA(s)of each condition included in the electronic Initial Case Report (eICR)     \n- Identify who (a PHA or an intermediary) prepared the Reportability Response     \n- Indicate whether the eICR has been sent to one or more PHA(s)     \n- Identify which PHA(s) has/have been sent the eICR     \n- Provide contact information for the responsible PHA(s)     \n- Provide suggested or required clinical follow-up activities from the responsible PHA(s), including any additional reporting needs or infection control activities     \n- Provide access to clinical support resources suggested by the responsible PHA(s) for identified reportable conditions     \n- Confirm eICR receipt and processing     \n\nA Reportability Response will also, when requested, be shared with the responsible PHAs (when they have not constructed it) for their internal use, so they understand what has been shared with clinical care and, and to monitor/audit decision support algorithm effectivesness and implementation. When a condition is considered reportable to more than one PHA, the Reportability Response can be helpful in communicating reporting that has been done to other PHAs.     \n\nThe Reportability Response Communication is also structured to allow:     \n\n- Notification, alerting, routing and queueing in work or message management systems for healthcare personnel     \n- Dynamic and static URIs for supplemental data collection and the provision of information resources",
        "mustSupport": true,
        "mapping": [
          {
            "identity": "cda-rr",
            "map": "Reportability Response Document (RR)"
          }
        ]
      },
      {
        "id": "Communication.text",
        "path": "Communication.text",
        "definition": "The narrative structure of a Reportability Response Comminication can take two different forms, depending on the processing status of the eICR Composition document to which it is a response. These forms are as follows: \n\n- If the eICR was processed, then the narrative text will be populated with data from Communication.topic, Communication.payload[Reportability Response Summary], Communication.payload[Relevant Reportable Condition], and Communication.payload[Electronic Initial Case Report Information] \n\n- If the eICR was not processed and has errors, then the narrative text will only be populated with data from Communication.payload[Electronic Initial Case Report Information]",
        "min": 1,
        "constraint": [
          {
            "key": "nar-1",
            "severity": "error",
            "human": "Text narrative SHOULD conform to requirements laid out on the Narrative Guidance tab",
            "expression": "not(tested)"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.extension",
        "path": "Communication.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Communication.extension:reportabilityResponsePriority",
        "path": "Communication.extension",
        "sliceName": "reportabilityResponsePriority",
        "short": "Reportability Response Priority",
        "definition": "Rrepresents a priority for the reportability response communication overall. It has been calculated from the highest priority of any included External Resources or the highest priority of included conditions based on a separate, jurisdictionally developed priority list.\r\nThis “communication”-level priority should be used for EHR workflow including notification, alerting, routing and queueing.",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://hl7.org/fhir/us/ecr/StructureDefinition/extension-rr-priority"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.identifier",
        "path": "Communication.identifier",
        "min": 1,
        "max": "1",
        "example": [
          {
            "label": "General",
            "valueIdentifier": {
              "system": "http://acme.org/identifiers",
              "value": "RR12346"
            }
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "cda-rr",
            "map": "Reportability Response Document (RR)/id"
          }
        ]
      },
      {
        "id": "Communication.category",
        "path": "Communication.category",
        "min": 1,
        "max": "1",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "88085-6",
              "display": "Reportability Response Report Public Health"
            }
          ]
        },
        "mustSupport": true,
        "isModifier": false,
        "mapping": [
          {
            "identity": "cda-rr",
            "map": "Reportability Response/code"
          }
        ]
      },
      {
        "id": "Communication.subject",
        "path": "Communication.subject",
        "short": "Patient",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/us/ecr/StructureDefinition/ecr-patient"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueReference": {
              "reference": "Patient/ecr-patient-eve-everywoman",
              "display": "Eve Everywoman"
            }
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.recipient",
        "path": "Communication.recipient",
        "comment": "Reporting may be identified for multiple PHAs by the PHA system (or its intermediary) (because the patient's residence and the provider location are in separate jurisdictions) including other identified organization (such as an HIE) to which the eICR (if deemed reportable) and/or the Reportability Response will be routed.",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/PractitionerRole"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueReference": {
              "reference": "PractitionerRole/ecr-practitionerrole-henry-seven",
              "display": "Henry Seven, MD"
            }
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.topic",
        "path": "Communication.topic",
        "short": "Reportability Response Subject",
        "definition": "Contains a short high-level description of the determination of reportability. This information can be used to route and prioritize Reportability Responses in a work queue or an email subject.",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Communication.topic.reference",
        "path": "Communication.topic.reference",
        "max": "0"
      },
      {
        "id": "Communication.topic.identifier",
        "path": "Communication.topic.identifier",
        "max": "0"
      },
      {
        "id": "Communication.topic.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Communication.topic.display",
        "short": "Reportability Response Subject text",
        "definition": "Contains a short high-level description of the determination of reportability.",
        "min": 1,
        "example": [
          {
            "label": "General",
            "valueString": "Public Health Reporting Communication: one or more conditions are reportable, or may be reportable to public health."
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.context",
        "path": "Communication.context",
        "short": "eICR Encounter",
        "definition": "The encounter in which the eICR was triggered.",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-encounter"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.sent",
        "path": "Communication.sent",
        "min": 1
      },
      {
        "id": "Communication.sender",
        "path": "Communication.sender",
        "short": "Author",
        "definition": "For the Reportability Response communication, this will most likely be the software that is generating the response, though this will not always the be case.",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.payload",
        "path": "Communication.payload",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "id"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Communication.payload:sliceReportabilityResponseSummary",
        "path": "Communication.payload",
        "sliceName": "sliceReportabilityResponseSummary",
        "short": "Reportability Response Summary",
        "definition": "This payload slice is present in the Reportabilty Response if the eICR was processed and is not present if the eICR was not processed. Contains a detailed text description of the reportable condition(s) including actions the provider needs to take, any supplemental information that may be required, and where the initial case report was sent.",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceReportabilityResponseSummary.id",
        "path": "Communication.payload.id",
        "min": 1,
        "fixedString": "reportability-response-summary",
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceReportabilityResponseSummary.content[x]:contentString",
        "path": "Communication.payload.contentString",
        "sliceName": "contentString",
        "short": "Reportability Response Summary text",
        "definition": "Contains a detailed text description of the reportable condition(s) including actions the provider needs to take, any supplemental information that may be required, and where the initial case report was sent.",
        "type": [
          {
            "code": "string"
          }
        ],
        "example": [
          {
            "label": "General",
            "valueString": "Your organization electronically submitted an initial case report to determine if reporting to public health is needed for a patient. \"Zika virus disease (disorder)\" is reportable to \"State Department of Health\". An initial case report was sent to \"State Department of Health\". Additional information may be required for this report."
          }
        ]
      },
      {
        "id": "Communication.payload:sliceRelevantReportableCondition",
        "path": "Communication.payload",
        "sliceName": "sliceRelevantReportableCondition",
        "short": "Relevant Reportable Condition",
        "definition": "This payload slice is present in the Reportabilty Response if the eICR was processed and is not present if the eICR was not processed. It contains a Reportability Response PlanDefinition and repeats for each uniqe condition-PHA pair.",
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceRelevantReportableCondition.id",
        "path": "Communication.payload.id",
        "min": 1,
        "fixedString": "relevant-reportable-condition",
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceRelevantReportableCondition.content[x]:contentReference",
        "path": "Communication.payload.contentReference",
        "sliceName": "contentReference",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/us/ecr/StructureDefinition/rr-relevant-reportable-condition-plandefinition"
          }
        ]
      },
      {
        "id": "Communication.payload:sliceEICRInformation",
        "path": "Communication.payload",
        "sliceName": "sliceEICRInformation",
        "short": "Electronic Initial Case Report Information",
        "definition": "This payload contains information about the eICR Composition to which this Communication is a response. The date/time of receipt and a document reference are represented in the referenced Electronic Initial Case Report Composition Profile and the processing status of the eICR Composition is contained in the eICR Processing Status profile. If the eICR Composition was manually initiated by a healthcare provider, this is indicated by the presence of the Manually Initiated eICR extension.\r\n\r\nThis payload is always present in the Reportability Response Communication.\r\n\r\nThe text element (narrative block) in this section is only populated and displayed when the eICR CDA document was not processed (eICR Processing Status/code=\"RRVS22\", \"eICR was not processed – error\") and that text element contains the eICR processing status reason(s).\r\n",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceEICRInformation.id",
        "path": "Communication.payload.id",
        "min": 1,
        "fixedString": "eicr-information",
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceEICRInformation.extension",
        "path": "Communication.payload.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Communication.payload:sliceEICRInformation.extension:eICRProcessingStatus",
        "path": "Communication.payload.extension",
        "sliceName": "eICRProcessingStatus",
        "short": "eICR Processing Status",
        "definition": "Optional Extension Element - found in all resources.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://hl7.org/fhir/us/ecr/StructureDefinition/extension-rr-eicr-processing-status"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceEICRInformation.extension:eICRProcessingStatus.id",
        "path": "Communication.payload.extension.id",
        "min": 1,
        "fixedString": "eicr-processing-status",
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceEICRInformation.extension:eICRProcessingStatus.url",
        "path": "Communication.payload.extension.url",
        "fixedUri": "http://hl7.org/fhir/us/ecr/StructureDefinition/extension-rr-eicr-processing-status"
      },
      {
        "id": "Communication.payload:sliceEICRInformation.extension:manuallyInitiatedEICR",
        "path": "Communication.payload.extension",
        "sliceName": "manuallyInitiatedEICR",
        "short": "Manually Initiated eICR",
        "definition": "This extension indicates whether or not the eICR CDA document for which this Reportability Response is a response, was manually initiated by the provider. The eICR could also contain RCTC trigger codes.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://hl7.org/fhir/us/ecr/StructureDefinition/extension-rr-manually-initiated-eicr"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceEICRInformation.extension:manuallyInitiatedEICR.id",
        "path": "Communication.payload.extension.id",
        "min": 1,
        "fixedString": "manually-initiated-eicr",
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceEICRInformation.extension:manuallyInitiatedEICR.url",
        "path": "Communication.payload.extension.url",
        "fixedUri": "http://hl7.org/fhir/us/ecr/StructureDefinition/extension-rr-manually-initiated-eicr"
      },
      {
        "id": "Communication.payload:sliceEICRInformation.extension:extensionEICRReceiptTime",
        "path": "Communication.payload.extension",
        "sliceName": "extensionEICRReceiptTime",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://hl7.org/fhir/us/ecr/StructureDefinition/extension-rr-eicr-receipt-time"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceEICRInformation.content[x]:contentReference",
        "path": "Communication.payload.contentReference",
        "sliceName": "contentReference",
        "short": "Reference to eICR Composition",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-composition"
          }
        ]
      },
      {
        "id": "Communication.payload:sliceEICRInformation.content[x]:contentReference.reference",
        "path": "Communication.payload.contentReference.reference",
        "mustSupport": false
      },
      {
        "id": "Communication.payload:sliceEICRInformation.content[x]:contentReference.identifier",
        "path": "Communication.payload.contentReference.identifier",
        "short": "eICR Composition id",
        "mustSupport": true
      },
      {
        "id": "Communication.payload:sliceEICRInformation.content[x]:contentReference.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Communication.payload.contentReference.display",
        "short": "eICR filename (or other identifying string)",
        "definition": "The filename (or other identifying string) is recommended primarily for dealing with eICR error cases. In the case where an eICR document is unreadable for some reason, it is possible that the only identifying information is the eICR filename (or other identifying string).",
        "example": [
          {
            "label": "General",
            "valueString": "eicr-composition-zika.xml"
          }
        ],
        "mustSupport": true
      }
    ]
  }
}