• 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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()

• rim: n/a
• rim: Entity. Role, or Act
• rim: Entity, Role, or Act
• w5: administrative.individual
• v2: PRD (as one example)
• rim: Role
• interface: ParticipantLiving
• servd: Provider

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• rim: N/A

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 its narrative along with other profiles, value sets, etc.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

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).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a

Contained resources do not have a 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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• rim: N/A
• rim: Act.text?

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.

• rim: n/a
• rim: Entity. Role, or Act
• rim: N/A

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.

• 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()

• rim: n/a
• rim: N/A

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.

• 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()

• rim: n/a
• rim: N/A

Often, specific identities are assigned for the agent.

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
  value.exists()

• 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
• interface: Participant.identifier
• servd: ./Identifiers

Need to be able to mark a practitioner record as not to be used because it was created in error.

If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• w5: FiveWs.status
• rim: ./statusCode
• interface: Participant.active

The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

In general, select the value to be used in the ResourceReference.display based on this:

1. There is more than 1 name
2. Use = usual
3. Period is current to the date of the usage
4. Use = official
5. Other order as decided by internal business rules.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: XPN
• rim: EN (actually, PN)
• servd: ProviderName
• v2: XCN Components
• rim: ./name
• interface: Participant.name
• servd: ./PreferredName (GivenNames, FamilyName, TitleCode)

• rim: n/a

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.

• 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()

• rim: n/a
• rim: N/A

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: XPN.7, but often indicated by which field contains the name
• rim: unique(./use)
• servd: ./NamePurpose

A renderable, unencoded form.

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: implied by XPN.11
• rim: ./formatted

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: XPN.1/FN.1
• rim: ./part[partType = FAM]
• servd: ./FamilyName

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: XPN.2 + XPN.3
• rim: ./part[partType = GIV]
• servd: ./GivenNames

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: XPN.5
• rim: ./part[partType = PFX]
• servd: ./TitleCode

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: XPN/4
• rim: ./part[partType = SFX]

Allows names to be placed in historical context.

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.

• 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 or equal value than end
  start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())

• rim: n/a
• v2: DR
• rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
• v2: XPN.13 + XPN.14
• rim: ./usablePeriod[type="IVL<TS>"]
• servd: ./StartDate and ./EndDate

Need to know how to reach a practitioner independent to any roles the practitioner may have.

Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.

• 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()

• rim: n/a
• v2: XTN
• rim: TEL
• servd: ContactPoint
• v2: PRT-15, STF-10, ROL-12
• rim: ./telecom
• interface: ParticipantContactable.telecom
• servd: ./ContactPoints

Needed to address the person correctly.

Note that FHIR strings SHALL NOT exceed 1,048,576 (1024*1024) characters in size

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: STF-5
• rim: ./administrativeGender
• interface: ParticipantLiving.gender
• servd: ./GenderCode

Needed for identification.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: STF-6
• rim: ./birthTime
• interface: ParticipantLiving.birthDate
• servd: (not represented in ServD)

If there's no value in the instance, it means there is no statement on whether or not the practitioner is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime

The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: XAD
• rim: AD
• servd: Address
• v2: ORC-24, STF-11, ROL-11, PRT-14
• rim: ./addr
• interface: ParticipantContactable.address
• servd: ./Addresses

Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.

When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• att-1: If the Attachment has data, it SHALL have a contentType
  data.empty() or contentType.exists()

• rim: n/a
• v2: ED/RP
• rim: ED
• rim: ./subjectOf/ObservationEvent[code="photo"]/value
• interface: ParticipantLiving.photo
• servd: ./ImageURI (only supports the URI reference)

The PractitionerRole.specialty defines the functional role that they are practicing at a given organization or location. Those specialties may or might not require a qualification, and are not defined on the practitioner.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: CER?
• rim: .playingEntity.playingRole[classCode=QUAL].code
• servd: ./Qualifications

• rim: n/a

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.

• 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()

• rim: n/a
• rim: N/A

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.

• 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()

• rim: n/a
• rim: N/A

Often, specific identities are assigned for the qualification.

The rules of the identifier.type determine if a check digit is part of the ID value or sent separately, such as through the checkDigit extension.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())
• ident-1: Identifier with no value has limited utility. If communicating that an identifier value has been suppressed or missing, the value element SHOULD be present with an extension indicating the missing semantic - e.g. data-absent-reason
  value.exists()

• 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
• rim: .playingEntity.playingRole[classCode=QUAL].id

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.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: CE/CNE/CWE
• rim: CD
• orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
• rim: .playingEntity.playingRole[classCode=QUAL].code
• servd: ./Qualifications.Value

Qualifications are often for a limited period of time, and can be revoked.

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.

• 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 or equal value than end
  start.hasValue().not() or end.hasValue().not() or (start.lowBoundary() <= end.highBoundary())

• rim: n/a
• v2: DR
• rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
• rim: .playingEntity.playingRole[classCode=QUAL].effectiveTime
• servd: ./Qualifications.StartDate and ./Qualifications.EndDate

References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (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.

• 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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
• ref-2: At least one of reference, identifier and display SHALL be present (unless an extension is provided).
  reference.exists() or identifier.exists() or display.exists() or extension.exists()

• rim: n/a
• rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
• rim: .playingEntity.playingRole[classCode=QUAL].scoper

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Practitioner.Communication associations.

For animals, language is not a relevant field, and should be absent from the instance.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• rim: LanguageCommunication

• rim: n/a

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.

• 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()

• rim: n/a
• rim: N/A

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.

• 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()

• rim: n/a
• rim: N/A

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• v2: CE/CNE/CWE
• rim: CD
• orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
• v2: PID-15, LAN-2
• rim: player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

This language is specifically identified for communicating directly with the practitioner (typically un-related to patient communications).

• ele-1: All FHIR elements must have a @value or children
  hasValue() or (children().count() > id.count())

• rim: n/a
• rim: preferenceInd