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{
  "resourceType": "StructureDefinition",
  "id": "0175c4e8-6286-4a98-a433-7dfa28b04215",
  "url": "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-Consent",
  "version": "3.0.0",
  "name": "ConsentV3",
  "status": "active",
  "date": "2025-10-23",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Pattern"
    },
    {
      "identity": "v2",
      "uri": "http://hl7.org/v2",
      "name": "HL7 v2 Mapping"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    },
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/fivews",
      "name": "FiveWs Pattern Mapping"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Consent",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Consent",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Consent",
        "path": "Consent",
        "constraint": [
          {
            "key": "inv-1",
            "severity": "error",
            "human": "If consent performer is relatedPerson, provision purpose code MUST be \"SUPNWK\"",
            "expression": "performer.resolve().meta.profile.contains('RelatedPerson') implies provision.purpose[0].code='SUPNWK'"
          }
        ]
      },
      {
        "id": "Consent.meta",
        "path": "Consent.meta",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.meta.profile",
        "path": "Consent.meta.profile",
        "comment": "#### **_` FOR PCOI USAGE: The meta.profile = http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-Consent|3.0.0 `_** \r\n\r\nIt is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set.",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.identifier",
        "path": "Consent.identifier",
        "definition": "Unique identifier for this copy of the Consent Statement.\r\neHealth Ontario and Implementers will work together to define the value passed in this field, if any.",
        "comment": "This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.\r\nTBD if an identifier is necessary; this field can be used to store an identifier from the submitting system for reconciliation. DICS requires a msid from the Message Header (this value can come from the client, or could be HIAL/Gateway-assigned). CDR uses msgid from the SOAP Header <wsa:MessageID> from the SOAP request msg. CMTA or the gateway would need to turn/store this ID for future retrieval/reference.",
        "mustSupport": false
      },
      {
        "id": "Consent.identifier.use",
        "path": "Consent.identifier.use",
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use"
        }
      },
      {
        "id": "Consent.status",
        "path": "Consent.status",
        "definition": "Indicates the current state of this consent.\r\nFor consent overrides, this value will be fixed to \"active\".",
        "fixedCode": "active",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1"
        }
      },
      {
        "id": "Consent.scope",
        "path": "Consent.scope",
        "mustSupport": true
      },
      {
        "id": "Consent.scope.coding",
        "path": "Consent.scope.coding",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Consent.scope.coding.system",
        "path": "Consent.scope.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/consentscope",
        "mustSupport": true
      },
      {
        "id": "Consent.scope.coding.code",
        "path": "Consent.scope.coding.code",
        "min": 1,
        "fixedCode": "patient-privacy",
        "mustSupport": true
      },
      {
        "id": "Consent.scope.coding.display",
        "path": "Consent.scope.coding.display",
        "min": 1,
        "fixedString": "Privacy Consent",
        "mustSupport": true
      },
      {
        "id": "Consent.category",
        "path": "Consent.category",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Consent.category.coding",
        "path": "Consent.category.coding",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Consent.category.coding.system",
        "path": "Consent.category.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "mustSupport": true
      },
      {
        "id": "Consent.category.coding.code",
        "path": "Consent.category.coding.code",
        "min": 1,
        "fixedCode": "INFA",
        "mustSupport": true
      },
      {
        "id": "Consent.category.coding.display",
        "path": "Consent.category.coding.display",
        "min": 1,
        "fixedString": "information access",
        "mustSupport": true
      },
      {
        "id": "Consent.patient",
        "path": "Consent.patient",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-Patient"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.patient.reference",
        "path": "Consent.patient.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.performer",
        "path": "Consent.performer",
        "definition": "Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions.\r\nOnly Patient and RelatedPerson are in the scope of the current release. Practitioner-initiated Consent Override",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-Patient",
              "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-RelatedPerson",
              "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-Practitioner",
              "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-Organization"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.performer.reference",
        "path": "Consent.performer.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.organization",
        "path": "Consent.organization",
        "definition": "The organization that manages the consent, and the framework within which it is executed.\r\nFor PCOI, this captures the facility name and identifier of the \"Under Authority Of\" organization.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-Organization"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.organization.reference",
        "path": "Consent.organization.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.policy",
        "path": "Consent.policy",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Consent.policy.authority",
        "path": "Consent.policy.authority",
        "min": 1,
        "fixedUri": "http://www.ontario.ca",
        "mustSupport": true
      },
      {
        "id": "Consent.provision",
        "path": "Consent.provision",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.provision.type",
        "path": "Consent.provision.type",
        "min": 1,
        "fixedCode": "permit",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://hl7.org/fhir/ValueSet/consent-provision-type"
        }
      },
      {
        "id": "Consent.provision.period",
        "path": "Consent.provision.period",
        "definition": "The timeframe in this rule is valid.\r\n\r\nThis field is optional and will be ignored for processing in the current PCOI implementation. The consent override duration will be processed based on the time of receipt of the FHIR Consent resource, and not based on the payload's Consent.dateTime value (to prevent unintended behaviour based on incorrect payload dateTime)."
      },
      {
        "id": "Consent.provision.actor",
        "path": "Consent.provision.actor",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.role",
        "path": "Consent.provision.actor.role",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.role.coding",
        "path": "Consent.provision.actor.role.coding",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.role.coding.system",
        "path": "Consent.provision.actor.role.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.role.coding.code",
        "path": "Consent.provision.actor.role.coding.code",
        "min": 1,
        "fixedCode": "IRCP",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.role.coding.display",
        "path": "Consent.provision.actor.role.coding.display",
        "min": 1,
        "fixedString": "information recipient",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.reference",
        "path": "Consent.provision.actor.reference",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-consent-pcoi-profile-Practitioner"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.reference.reference",
        "path": "Consent.provision.actor.reference.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.provision.action",
        "path": "Consent.provision.action",
        "definition": "Actions controlled by this Rule.\r\n\r\nWhile this element may be used by some underlying lines of business (e.g. DHDR), the PCOI currently is not using this optional element. If sent, this element will not be processed by the PCOI.\r\n\r\nSee comments.",
        "comment": "Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.\r\n\r\nAs of FHIR R4, HL7 notes that \"At present, the only action in the understood and tested scope of this resource is 'read'\". (yet \"read\" is not one of the sample Consent Action Codes).\r\n\r\nThis element may be populated with the value \"use\", to align with the example binding and with the current DHDR implementation, but may require additional discussion. Note that DHDR V1 and V2 used value \"access\", while DHDR V3 used \"use\".",
        "mustSupport": true,
        "binding": {
          "strength": "required"
        }
      },
      {
        "id": "Consent.provision.action.coding",
        "path": "Consent.provision.action.coding",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.action.coding.system",
        "path": "Consent.provision.action.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/consentaction",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.action.coding.code",
        "path": "Consent.provision.action.coding.code",
        "min": 1,
        "fixedCode": "use",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.action.coding.display",
        "path": "Consent.provision.action.coding.display",
        "min": 1,
        "fixedString": "Use",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.purpose",
        "path": "Consent.provision.purpose",
        "definition": "The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule.\r\nThis element captures the \"reason for override\". Ontario legislation currently allows for:\r\n* Express Patient Consent [PATRQT]\r\n* Express Substitute Decision Maker Consent [SUPNWK}\r\n* Risk to Safety of Patient [OVRER]\r\n* Risk to Safety of Third Parites [OVRTPS]\r\nNot all systems will allow all three reasons for override, however. Please see additional documentation for details.",
        "min": 1,
        "max": "1",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "http://ehealthontario.ca/fhir/ValueSet/consent-pcoi-override-reason"
        }
      },
      {
        "id": "Consent.provision.purpose.system",
        "path": "Consent.provision.purpose.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.purpose.code",
        "path": "Consent.provision.purpose.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.provision.purpose.display",
        "path": "Consent.provision.purpose.display",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.provision.class",
        "path": "Consent.provision.class",
        "definition": "The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.\r\nThe classes identified will indicate the Ontario EHR repository for which the Consent Override is being requested. As additional Ontario EHR respositories are onboarded to the Provincial Consent Override Interface service, the bound ValueSet will be updated to include those repositories.",
        "min": 1,
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "Codes representing data domains for PCOI including OH Clinical Data Foundation, and legacy repositories",
          "valueSet": "http://ontariohealth.ca/fhir/pcoi/ValueSet/consent-content-class"
        }
      },
      {
        "id": "Consent.provision.class.system",
        "path": "Consent.provision.class.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.provision.class.code",
        "path": "Consent.provision.class.code",
        "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).\r\nThis will contain the gateway URI identifying the provincial EHR assets as a target for the consent override request",
        "comment": "#### **_`For this release, the supported values are http://ehealthontario.ca/fhir/StructureDefinition/ca-on-medications-profile-MedicationDispense for DHDR consent override or http://ehealthontario.ca/fhir/StructureDefinition/ca-on-lab-profile-DiagnosticReport for OLIS consent override`_**",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.provision.class.display",
        "path": "Consent.provision.class.display",
        "comment": "#### **_`For this release, the supported values are \"DHDR\" for DHDR consent override or \"OLIS\" for OLIS consent override`_**",
        "min": 1,
        "mustSupport": true
      }
    ]
  }
}

name : ConsentV3

{

}