FHIR Genomics Implementation Guide

Notice

Important: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
This Implementation Guide is currently in Draft and SHOULD NOT be used for development or active implementation without express direction from the NHS England Genomics Unit.

StructureDefinition UKCore-PractitionerRole

PractitionerRole resources SHOULD be used where information about both a practitioner and their role within a specific organization is required, e.g. as the ServiceRequest.requestor.

References to Practitioner and Organization resources SHOULD only be made via identifier, rather than appending Practitioner and Organization resources to test order bundles. Issues with referencing via identifier SHOULD be reported to the NHS England Genomics Unit for investigation.

Profile url	FHIR Module	Normative Status
https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole	UKCore	trial-use

UKCorePractitionerRole (PractitionerRole)	I		PractitionerRole	There are no (further) constraints on this element Element id PractitionerRole Short description Roles/organizations the practitioner is associated with Definition A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time. Data type PractitionerRole Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` Mappings rim: Entity. Role, or Act v2: PRD (as one example) rim: Role servd: ServiceSiteProvider
id	Σ	0..1	string	There are no (further) constraints on this element Element id PractitionerRole.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id PractitionerRole.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id PractitionerRole.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id PractitionerRole.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id PractitionerRole.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id PractitionerRole.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id PractitionerRole.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id PractitionerRole.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id PractitionerRole.identifier Short description Business Identifiers that are specific to a role/location Definition Business Identifiers that are specific to a role/location. Requirements Often, specific identities are assigned for the agent. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier w5: FiveWs.identifier v2: PRD-7 (or XCN.1) rim: .id servd: ./Identifiers
active	S Σ	0..1	boolean	Element id PractitionerRole.active Short description Whether this practitioner role record is in active use. Definition Whether this practitioner role record is in active use. Requirements Need to be able to mark a practitioner role record as not to be used because it was created in error, or otherwise no longer in active use. Comments If this value is false, you may refer to the period to see when the role was in active use. If there is no period specified, no inference can be made about when it was active. Meaning when missing This resource is generally assumed to be active if no value is provided for the active element Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a w5: FiveWs.status v2: STF-7 rim: .statusCode
period	S Σ I	0..1	Period	Element id PractitionerRole.period Short description The period during which the practitioner is authorized to perform in these role(s). Definition The period during which the person is authorized to act as a practitioner in these role(s) for the organization. Requirements Even after the agencies is revoked, the fact that it existed must still be recorded. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] w5: FiveWs.done[x] v2: PRD-8/9 / PRA-5.4 rim: .performance[@typeCode <= 'PPRF'].ActDefinitionOrEvent.effectiveTime servd: (ServD maps Practitioners and Organizations via another entity, so this concept is not available)
practitioner	S Σ I	0..1	Reference(Practitioner)	Element id PractitionerRole.practitioner Short description Practitioner that is able to provide the defined services for the organization. Definition Practitioner that is able to provide the defined services for the organization. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Practitioner) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .player
organization	S Σ I	0..1	Reference(Organization)	Element id PractitionerRole.organization Short description Organization where the roles are available. Definition The organization where the Practitioner performs the roles associated. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .scoper
code	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id PractitionerRole.code Short description Roles which this practitioner may perform Definition Roles which this practitioner is authorized to perform for the organization. Requirements Need to know what authority the practitioner has - what can they do? Comments A person may have more than one role. Data type CodeableConcept Binding The role a person plays representing an organization. PractitionerRole (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PRD-1 / STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 rim: .code servd: (ServD maps Practitioners and Organizations via another entity, so this concept is not available)
specialty	S Σ	0..*	CodeableConceptBinding	Element id PractitionerRole.specialty Short description Specific specialty of the practitioner. Definition Specific specialty of the practitioner. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Specific specialty associated with the agency. UKCorePracticeSettingCode (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PRA-5 rim: .player.HealthCareProvider[@classCode = 'PROV'].code servd: ./Specialty
location	S Σ I	0..*	Reference(Location)	Element id PractitionerRole.location Short description The location(s) at which this practitioner provides care. Definition The location(s) at which this practitioner provides care. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.where[x] rim: .performance.ActDefinitionOrEvent.ServiceDeliveryLocation[@classCode = 'SDLOC'] servd: (ServD maps Practitioners and Organizations via another entity, so this concept is not available)<br/> However these are accessed via the Site.ServiceSite.ServiceSiteProvider record. (The Site has the location)
healthcareService	I	0..*	Reference(HealthcareService)	There are no (further) constraints on this element Element id PractitionerRole.healthcareService Short description The list of healthcare services that this worker provides for this role's Organization/Location(s) Definition The list of healthcare services that this worker provides for this role's Organization/Location(s). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(HealthcareService) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) v2: EDU-2 / AFF-3 rim: .player.QualifiedEntity[@classCode = 'QUAL'].code
telecom	S Σ I	0..*	ContactPoint	Element id PractitionerRole.telecom Short description Contact details that are specific to the role/location/service. Definition Contact details that are specific to the role/location/service. Requirements Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these. Data type ContactPoint Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` cpt-2: A system is required if a value is provided. `value.empty() or system.exists()` Mappings rim: n/a v2: XTN rim: TEL servd: ContactPoint rim: .telecom
availableTime		0..*	BackboneElement	There are no (further) constraints on this element Element id PractitionerRole.availableTime Short description Times the Service Site is available Definition A collection of times the practitioner is available or performing this role at the location and/or healthcareservice. Comments More detailed availability information may be provided in associated Schedule/Slot resources. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .effectiveTime
id		0..1	string	There are no (further) constraints on this element Element id PractitionerRole.availableTime.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id PractitionerRole.availableTime.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id PractitionerRole.availableTime.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
daysOfWeek		0..*	codeBinding	There are no (further) constraints on this element Element id PractitionerRole.availableTime.daysOfWeek Short description mon \| tue \| wed \| thu \| fri \| sat \| sun Definition Indicates which days of the week are available between the start and end Times. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The days of the week. DaysOfWeek (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .effectiveTime
allDay		0..1	boolean	There are no (further) constraints on this element Element id PractitionerRole.availableTime.allDay Short description Always available? e.g. 24 hour service Definition Is this always available? (hence times are irrelevant) e.g. 24 hour service. Data type boolean Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .effectiveTime
availableStartTime		0..1	time	There are no (further) constraints on this element Element id PractitionerRole.availableTime.availableStartTime Short description Opening time of day (ignored if allDay = true) Definition The opening time of day. Note: If the AllDay flag is set, then this time is ignored. Comments The timezone is expected to be for where this HealthcareService is provided at. Data type time Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .effectiveTime
availableEndTime		0..1	time	There are no (further) constraints on this element Element id PractitionerRole.availableTime.availableEndTime Short description Closing time of day (ignored if allDay = true) Definition The closing time of day. Note: If the AllDay flag is set, then this time is ignored. Comments The timezone is expected to be for where this HealthcareService is provided at. Data type time Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .effectiveTime
notAvailable		0..*	BackboneElement	There are no (further) constraints on this element Element id PractitionerRole.notAvailable Short description Not available during this time due to provided reason Definition The practitioner is not available or performing this role during this period of time due to the provided reason. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .effectiveTime
id		0..1	string	There are no (further) constraints on this element Element id PractitionerRole.notAvailable.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id PractitionerRole.notAvailable.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id PractitionerRole.notAvailable.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
description		1..1	string	There are no (further) constraints on this element Element id PractitionerRole.notAvailable.description Short description Reason presented to the user explaining why time not available Definition The reason that can be presented to the user as to why this time is not available. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
during	I	0..1	Period	There are no (further) constraints on this element Element id PractitionerRole.notAvailable.during Short description Service not available from this date Definition Service is not available (seasonally or for a public holiday) from this date. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] rim: .effectiveTime
availabilityExceptions		0..1	string	There are no (further) constraints on this element Element id PractitionerRole.availabilityExceptions Short description Description of availability exceptions Definition A description of site availability exceptions, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as details in the available Times and not available Times. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: .effectiveTime
endpoint	I	0..*	Reference(Endpoint)	There are no (further) constraints on this element Element id PractitionerRole.endpoint Short description Technical endpoints providing access to services operated for the practitioner with this role Definition Technical endpoints providing access to services operated for the practitioner with this role. Requirements Organizations have multiple systems that provide various services and ,ay also be different for practitioners too. So the endpoint satisfies the need to be able to define the technical connection details for how to connect to them, and for what purpose. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Endpoint) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)

FHIR	MDS	HL7v2
PractitionerRole.practitioner	Requestor - Full name, Requestor - Professional registration number, Requestor - Professional registration number type, Additional contact - Full name, Additional contact - Professional registration number, Additional contact - Professional registration number type, Patient - GP full name, Patient - GP GMC number, Previous genomic report - Report performer full name, Previous genomic report - Original requester full name, Previous non genomic report - Report performer full name, Previous non genomic report - Original requester full name	ORC-12, ORC-12.1, ORC-12.9, PD1-4.2 and PD1-4.3, PD1-4.1, OBX-16, ORC-12
PractitionerRole.code	Requestor - Job Title, Additional contact - Job Title	CTD-1
PractitionerRole.specialty	Requestor - Current Specialty, Requestor - Department name, Additional contact - Current Specialty, Additional contact - Department name	Additional CTD-1 segments
PractitionerRole.telecom	Requestor - Phone, Requestor - Email address, Requestor - Genomic report delivery method, Requestor - Central email for address and reporting (many), Additional contact - Phone, Additional contact - Email address, Additional contact - Genomic report delivery method, Additional contact - Central email for address and reporting (many)	ORC-14
PractitionerRole.organization	Requestor - Organization name, Requestor - Organization address, Requestor - Organization ODS code, Additional contact - Organization name, address and ODS code, Additional contact - Organization address, Additional contact - Organization ODS code, Patient - GP Practice ODS Code, Previous genomic report - Report performer organisation ODS code, Previous genomic report - Original requester organisation ODS code, Previous non genomic report - Report performer organisation ODS code, Previous non genomic report - Original requester organisation ODS code	ORC-21, ORC-22, ORC-21.10, OBX-23.10
PractitionerRole.healthcareService	PLCM activity - ODS code of the laboratory site delivering requested test, PLCM activity - Commissioned service category code	Additional CTD-1 segments

Propose a change to UKCore-PractitionerRole

practitioner

SHALL be present. Users SHOULD reference practitioners using an appropriate naming system within the NHS defined within the NHS England IG .Display name MAY be included to aid readability and verification of included identifiers.

 "practitioner": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/sds-user-id",
            "value": "9999999999"
        },
        "display": "Dr. Gene Smith"
    },

organization

SHALL be present. Users SHOULD reference organizations using an ODS code. Display name MAY be included to aid readability and verification of included identifiers. Requester ODS codes SHOULD use the lowest level site code rather than trust code (most granular code available) where possible, to aid contact retrieval.

 "organization": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/ods-organization-code",
            "value": "RGT01"
        },
        "display": "Addenbrooke's Hospital"
    },

specialty

The specialty field SHOULD be used to record department for the requesting clinician, issues with the use of this field, including issues with the [bound UK Core ValueSet](https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode) not representing certain departments SHOULD be reported to the NHS England Genomics Unit

"specialty":  [
        {
            "coding":  [
                {
                    "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode",
                    "code": "120",
                    "display": "Ear Nose and Throat"
                }
            ]
        }
    ],

telecom

The telecom field SHOULD be used to record contact details for the practitioner. For central mailboxes, e.g. those used for providing reports back to the requester, these SHOULD be marked with an appropriate 'contactpoint-comment' extension. Additionally, where are there multiple Practitioners involved in providing care, the contact details for each Practitioners for that location (or service) SHOULD be specified.

"telecom":  [
        {
            "system": "phone",
            "value": "01223586638"
        },
        {
            "system": "email",
            "value": "gene.smith@nhs.net"
        },
        {
            "system": "email",
            "value": "Add-tr.entsecretaries@nhs.net",
            "extension":  [
                {
                    "url": "http://hl7.org/fhir/StructureDefinition/contactpoint-comment",
                    "valueString": "reporting"
                }
            ]
        }
    ]