Resuscitation status
Parameter Case Report Form and Response Options
Do-not-resuscitate-order | Yes | No | Unknown |
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For resuscitation | ☐ | ☐ | ☐ |
This profile constrains the FHIR Consent resource to cover the do-not-resuscitate order of a patient.
Consent.scope is the type of consent and shall have a fixed value of 'adr' for Advanced Care Directive.
Consent.category further specifies the scope of this consent. It has a fixed value of 'dnr' for 'Do Not Resuscitate'.
Consent.provision.code contains the content of this consent in coded form. This can be set to Yes - For resuscitation or No - Not for resuscitation. If the content is unknown, the dataAbsentReason Extension can be used and set to 'unknown'.
Profile - Do-Not-Resuscitate Order
Snapshot
Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/do-not-resuscitate-order
DoNotResuscitateOrder (Consent) | I | Consent | There are no (further) constraints on this element Element idConsent A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time DefinitionA record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.
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id | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idConsent.meta Metadata about the resource DefinitionThe 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.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idConsent.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idConsent.language Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
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text | 0..1 | Narrative | There are no (further) constraints on this element Element idConsent.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idConsent.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idConsent.identifier Identifier for this record (external references) DefinitionUnique identifier for this copy of the Consent Statement. 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.
General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idConsent.status draft | proposed | active | rejected | inactive | entered-in-error DefinitionIndicates the current state of this consent. The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid. Indicates the state of the consent.
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scope | S Σ ?! | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idConsent.scope Which of the four areas this resource covers (extensible) DefinitionA selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. 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. The four anticipated uses for the Consent Resource.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.scope.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.scope.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | S Σ | 1..* | Coding | There are no (further) constraints on this element Element idConsent.scope.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.scope.coding.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.scope.coding.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | Element idConsent.scope.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
http://terminology.hl7.org/CodeSystem/consentscope
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.scope.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 1..1 | codeFixed Value | Element idConsent.scope.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
adr
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.scope.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idConsent.scope.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.scope.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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category | S Σ | 1..* | CodeableConceptBinding | There are no (further) constraints on this element Element idConsent.category Classification of the consent statement - for indexing/retrieval DefinitionA classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. 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. A classification of the type of consents found in a consent statement.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.category.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.category.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | S Σ | 1..* | Coding | There are no (further) constraints on this element Element idConsent.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.category.coding.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.category.coding.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uriFixed Value | Element idConsent.category.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
http://terminology.hl7.org/CodeSystem/consentcategorycodes
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.category.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 1..1 | codeFixed Value | Element idConsent.category.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
dnr
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.category.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idConsent.category.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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patient | S Σ I | 1..1 | Reference(Patient) | There are no (further) constraints on this element Element idConsent.patient Who the consent applies to DefinitionThe patient/healthcare consumer to whom this consent applies. Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.
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dateTime | S Σ | 1..1 | dateTime | There are no (further) constraints on this element Element idConsent.dateTime When this Consent was created or indexed DefinitionWhen this Consent was issued / created / indexed. This is not the time of the original consent, but the time that this statement was made or derived.
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performer | Σ I | 0..* | Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) | There are no (further) constraints on this element Element idConsent.performer Who is agreeing to the policy and rules Alternate namesconsentor DefinitionEither 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. Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) Constraints
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organization | Σ I | 0..* | Reference(Organization) | There are no (further) constraints on this element Element idConsent.organization Custodian of the consent Alternate namescustodian DefinitionThe organization that manages the consent, and the framework within which it is executed. 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.
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source[x] | Σ | 0..1 | There are no (further) constraints on this element Element idConsent.source[x] Source from which this consent is taken DefinitionThe source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.
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sourceAttachment | Attachment | There are no (further) constraints on this element Data type | ||
sourceReference | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) | There are no (further) constraints on this element Data type Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) | ||
policy | 0..* | BackboneElement | There are no (further) constraints on this element Element idConsent.policy Policies covered by this consent DefinitionThe references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.policy.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.policy.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.policy.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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authority | I | 0..1 | uri | There are no (further) constraints on this element Element idConsent.policy.authority Enforcement source for policy DefinitionEntity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. see http://en.wikipedia.org/wiki/Uniform_resource_identifier
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uri | I | 0..1 | uri | There are no (further) constraints on this element Element idConsent.policy.uri Specific policy covered by this consent DefinitionThe references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. This element is for discoverability / documentation and does not modify or qualify the policy rules.
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policyRule | Σ I | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idConsent.policyRule Regulation that this consents to DefinitionA reference to the specific base computable regulation or policy. Might be a unique identifier of a policy set in XACML, or other rules engine. If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Regulatory policy examples.
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verification | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idConsent.verification Consent Verified by patient or family DefinitionWhether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.verification.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.verification.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.verification.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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verified | Σ | 1..1 | boolean | There are no (further) constraints on this element Element idConsent.verification.verified Has been verified DefinitionHas the instruction been verified.
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verifiedWith | I | 0..1 | Reference(Patient | RelatedPerson) | There are no (further) constraints on this element Element idConsent.verification.verifiedWith Person who verified DefinitionWho verified the instruction (Patient, Relative or other Authorized Person). 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. Reference(Patient | RelatedPerson) Constraints
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verificationDate | 0..1 | dateTime | There are no (further) constraints on this element Element idConsent.verification.verificationDate When consent verified DefinitionDate verification was collected.
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provision | S Σ | 1..1 | BackboneElement | There are no (further) constraints on this element Element idConsent.provision Constraints to the base Consent.policyRule DefinitionAn exception to the base policy of this consent. An exception can be an addition or removal of access permissions.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.provision.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.provision.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.provision.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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type | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idConsent.provision.type deny | permit DefinitionAction to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules. Note that FHIR strings SHALL NOT exceed 1MB in size How a rule statement is applied, such as adding additional consent or removing consent.
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idConsent.provision.period Timeframe for this rule DefinitionThe timeframe in this rule is valid. 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.
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actor | 0..* | BackboneElement | There are no (further) constraints on this element Element idConsent.provision.actor Who|what controlled by this rule (or group, by role) DefinitionWho or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). There is no specific actor associated with the exception
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.provision.actor.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.provision.actor.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.provision.actor.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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role | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idConsent.provision.actor.role How the actor is involved DefinitionHow the individual is involved in the resources content that is described in the exception. 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. How an actor is involved in the consent considerations.
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reference | I | 1..1 | Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) | There are no (further) constraints on this element Element idConsent.provision.actor.reference Resource for the actor (or group, by role) DefinitionThe resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). 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. Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) Constraints
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action | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idConsent.provision.action Actions controlled by this rule DefinitionActions controlled by this Rule. 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'. all actions Detailed codes for the consent action.
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securityLabel | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idConsent.provision.securityLabel Security Labels that define affected resources DefinitionA security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Security Labels from the Healthcare Privacy and Security Classification System.
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purpose | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idConsent.provision.purpose Context of activities covered by this rule DefinitionThe context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. When the purpose of use tag is on the data, access request purpose of use shall not conflict. What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.
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class | Σ | 0..* | CodingBinding | There are no (further) constraints on this element Element idConsent.provision.class e.g. Resource Type, Profile, CDA, etc. DefinitionThe 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. Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. The class (type) of information a consent rule covers.
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code | S Σ | 1..1 | CodeableConceptBinding | Element idConsent.provision.code e.g. LOINC or SNOMED CT code, etc. in the content DefinitionIf this code is found in an instance, then the rule applies. Typical use of this is a Document code with class = CDA. If this code is found in an instance, then the exception applies.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.provision.code.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.provision.code.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | S Σ | 1..* | Coding | There are no (further) constraints on this element Element idConsent.provision.code.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.provision.code.coding.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.provision.code.coding.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 1..1 | uri | There are no (further) constraints on this element Element idConsent.provision.code.coding.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. 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 reference to some definition that establishes the system clearly and unambiguously.
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.provision.code.coding.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 1..1 | code | There are no (further) constraints on this element Element idConsent.provision.code.coding.code Symbol in syntax defined by the system DefinitionA 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). Need to refer to a particular code in the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.provision.code.coding.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings SHALL NOT exceed 1MB in size
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idConsent.provision.code.coding.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idConsent.provision.code.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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dataPeriod | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idConsent.provision.dataPeriod Timeframe for data controlled by this rule DefinitionClinical or Operational Relevant period of time that bounds the data controlled by this rule. This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.
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data | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idConsent.provision.data Data controlled by this rule DefinitionThe resources controlled by this rule if specific resources are referenced. all data
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id | 0..1 | string | There are no (further) constraints on this element Element idConsent.provision.data.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.provision.data.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idConsent.provision.data.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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meaning | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idConsent.provision.data.meaning instance | related | dependents | authoredby DefinitionHow the resource reference is interpreted when testing consent restrictions. Note that FHIR strings SHALL NOT exceed 1MB in size How a resource reference is interpreted when testing consent restrictions.
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reference | Σ I | 1..1 | Reference(Resource) | There are no (further) constraints on this element Element idConsent.provision.data.reference The actual data reference DefinitionA reference to a specific resource that defines which resources are covered by this consent. 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.
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provision | 0..* | see (provision) | There are no (further) constraints on this element Element idConsent.provision.provision Nested Exception Rules DefinitionRules which provide exceptions to the base rule or subrules. |
ValueSets
Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/ValueSet/resuscitation-status
ValueSet 'DoNotResuscitateOrder'
Version | 1.0.6 |
Published by | Berlin Institute of Health at Charité (BIH) |
Status | Active |
Experimental | False |
Do-not-resuscitate (DNR) order in the context of Covid-19
Contact Information
Website: https://www.bihealth.org/en/re...
This value set includes codes from the following code systems:
The following codes from system: SNOMED_CT
Code Display 304252001 For resuscitation (finding) 304253006 Not for resuscitation (finding) 261665006 Unknown (qualifier value)
Examples
DNR-order For resuscitation
Example consent DNR-order
{ "resourceType": "Consent", "id": "do-not-resuscitate-order-for-resuscitation", "meta": { "profile": [ "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/do-not-resuscitate-order" ] }, "scope": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "adr", "display": "Advanced Care Directive" } ] }, "category": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentcategorycodes", "code": "dnr", "display": "Do Not Resuscitate" } ] } ], "status": "active", "patient": { "reference": "Patient/gecco-patient" }, "dateTime": "2021-09-01", "policy": [ { "uri": "https://www.aerzteblatt.de/archiv/65440/DNR-Anordnungen-Das-fehlende-Bindeglied" } ], "provision": { "code": [ { "coding": [ { "code": "304252001", "system": "http://snomed.info/sct", "display": "For resuscitation" } ] } ] } }
DNR-order Not For resuscitation
Example consent DNR-order
{ "resourceType": "Consent", "id": "do-not-resuscitate-order-not-for-resuscitation", "meta": { "profile": [ "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/do-not-resuscitate-order" ] }, "scope": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "adr", "display": "Advanced Care Directive" } ] }, "category": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentcategorycodes", "code": "dnr", "display": "Do Not Resuscitate" } ] } ], "status": "active", "patient": { "reference": "Patient/gecco-patient" }, "dateTime": "2021-09-01", "policy": [ { "uri": "https://www.aerzteblatt.de/archiv/65440/DNR-Anordnungen-Das-fehlende-Bindeglied" } ], "provision": { "code": [ { "coding": [ { "code": "304253006", "system": "http://snomed.info/sct", "display": "Not for resuscitation" } ] } ] } }
DNR-order Status Unknown
Example consent DNR-order
{ "resourceType": "Consent", "id": "do-not-resuscitate-order-unknown", "meta": { "profile": [ "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/do-not-resuscitate-order" ] }, "scope": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentscope", "code": "adr", "display": "Advanced Care Directive" } ] }, "category": [ { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/consentcategorycodes", "code": "dnr", "display": "Do Not Resuscitate" } ] } ], "status": "active", "patient": { "reference": "Patient/gecco-patient" }, "dateTime": "2021-09-01", "policy": [ { "uri": "https://www.aerzteblatt.de/archiv/65440/DNR-Anordnungen-Das-fehlende-Bindeglied" } ], "provision": { "code": [ { "coding": [ { "code": "261665006", "system": "http://snomed.info/sct", "display": "Unknown" } ] } ] } }