CA Core+ IGuide v0.2.0 DFT

Practitioner (CA-Core)

Additional information on this profile (including the JSON & XML structure and detailed element descriptions) can be found at package/structuredefinition-practitioner-ca-core.json

This profile imposes the CA Baseline (v1.1.7) Practitioner Profile.

Profile

Practitioner	I		Practitioner	There are no (further) constraints on this element Element id Practitioner Short description A person with a formal responsibility in the provisioning of healthcare or related services Definition A person who is directly or indirectly involved in the provisioning of healthcare. Data type Practitioner 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: Provider
id	Σ	0..1	string	There are no (further) constraints on this element Element id Practitioner.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 Practitioner.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 Practitioner.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 Practitioner.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 Practitioner.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 Practitioner.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 Practitioner.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 Practitioner.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	Element id Practitioner.identifier Short description An identifier for the person as this agent Definition An identifier that applies to this person in this role. Requirements Often, specific identities are assigned for the agent. Comments pCHDCF modelling for care team concepts (including provider identifiers) is still underway. The requirements to support certain types of identifiers (e.g., province/territory registration identifiers) across all use cases and decisions on whether the identifier requirements should apply to both Practitioner and PractitionerRole are still undefined. Furthermore, the ways that these identifiers will be differentiated for conformance testing purposes is still undefined (see comment on identifier.type). For this reason, slice modelling and application of obligations towards certain identifiers is not currently expressed in this profile. The profile will continue to evolve as care team details undergo data modelling in the pCHDCF. 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
id		0..1	string	There are no (further) constraints on this element Element id Practitioner.identifier.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 Practitioner.identifier.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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Practitioner.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	Element id Practitioner.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments The value in identifier.type is typically used to differentiate between identifiers that serve distinct purposes (e.g., Medical License Number, Regional Registry ID, Health Plan Identifier). Profiles typically use the identifier.type to differentiate between expectations that are expressed for some identifier types but not others. However, current implementations of practitioner identifiers in Canada use the identifier.type of 'Provider Number' (coded as 'PRN') to convey a number of different types of identifiers (e.g., registration number, license numbers, and billing numbers). Should there be expectations in the future for this profile to differentiate between these identifiers, current typing practices may need to change and/or further details may need to be used (e.g., identifier.system) to differentiate between concepts like registration number, license number, and billing number. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (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: CX.5 rim: Role.code or implied by context pCHDCF: Provider Provincial/Territorial Registration Number* pCHDCF: Provider Province/Territory Billing Number* pCHDCF: Provider National Unique Identifier*
system	Σ	0..1	uri	Element id Practitioner.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings rim: n/a v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType pCHDCF: Provider Provincial/Territorial Registration Number* pCHDCF: Provider Province/Territory Billing Number* pCHDCF: Provider National Unique Identifier*
value	Σ	0..1	string	Element id Practitioner.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings rim: n/a v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value pCHDCF: Provider Provincial/Territorial Registration Number pCHDCF: Provider Province/Territory Billing Number pCHDCF: Provider National Unique Identifier*
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Practitioner.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. 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"] v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Practitioner.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. 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) v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
active	Σ	0..1	boolean	There are no (further) constraints on this element Element id Practitioner.active Short description Whether this practitioner's record is in active use Definition Whether this practitioner's record is in active use. Requirements Need to be able to mark a practitioner record as not to be used because it was created in error. Comments 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. 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 rim: ./statusCode
name	Σ	0..*	HumanName	There are no (further) constraints on this element Element id Practitioner.name Short description The name(s) associated with the practitioner Definition The name(s) associated with the practitioner. Requirements 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. Comments 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: There is more than 1 name Use = usual Period is current to the date of the usage Use = official Other order as decided by internal business rules. Data type HumanName Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: XPN rim: EN (actually, PN) servd: ProviderName v2: XCN Components rim: ./name servd: ./PreferredName (GivenNames, FamilyName, TitleCode)
id		0..1	string	There are no (further) constraints on this element Element id Practitioner.name.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 Practitioner.name.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
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Practitioner.name.use Short description usual \| official \| temp \| nickname \| anonymous \| old \| maiden Definition Identifies the purpose for this name. Requirements Allows the appropriate name for a particular context of use to be selected from among a set of names. Comments Applications can assume that a name is current unless it explicitly says that it is temporary or old. Data type code Binding The use of a human name. NameUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: XPN.7, but often indicated by which field contains the name rim: unique(./use) servd: ./NamePurpose
text	Σ	0..1	string	Element id Practitioner.name.text Short description Text representation of the full name Definition Text representation of the full name. Due to the cultural variance around the world a consuming system may not know how to present the name correctly; moreover not all the parts of the name go in given or family. Creators are therefore strongly encouraged to provide through this element a presented version of the name. Future versions of this guide may require this element Requirements A renderable, unencoded form. Comments 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. 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 v2: implied by XPN.11 rim: ./formatted pCHDCF: Provider Name*
family	Σ	0..1	string	Element id Practitioner.name.family Short description Family name (often called 'Surname') Alternate names surname Definition The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father. Comments Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures). 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 v2: XPN.1/FN.1 rim: ./part[partType = FAM] servd: ./FamilyName pCHDCF: Provider Last Name
given	Σ	0..*	string	Element id Practitioner.name.given Short description Given names (not always 'first'). Includes middle names Alternate names first name, middle name Definition Given name. Comments 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. 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 v2: XPN.2 + XPN.3 rim: ./part[partType = GIV] servd: ./GivenNames pCHDCF: Provider First Name
prefix	Σ	0..*	string	There are no (further) constraints on this element Element id Practitioner.name.prefix Short description Parts that come before the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name. 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 v2: XPN.5 rim: ./part[partType = PFX] servd: ./TitleCode
suffix	Σ	0..*	string	There are no (further) constraints on this element Element id Practitioner.name.suffix Short description Parts that come after the name Definition Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name. 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 v2: XPN/4 rim: ./part[partType = SFX]
period	Σ I	0..1	Period	There are no (further) constraints on this element Element id Practitioner.name.period Short description Time period when name was/is in use Definition Indicates the period of time when this name was valid for the named person. Requirements Allows names to be placed in historical context. 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"] v2: XPN.13 + XPN.14 rim: ./usablePeriod[type="IVL<TS>"] servd: ./StartDate and ./EndDate
telecom	Σ I	0..*	ContactPoint	Element id Practitioner.telecom Short description A contact detail for the practitioner (that apply to all roles) Definition A contact detail for the practitioner, e.g. a telephone number or an email address. Requirements Need to know how to reach a practitioner independent to any roles the practitioner may have. Comments Although the provider phone number and provider email concepts are expressed in the pCHDCF materials, their current definition does not distinctly identify the resource target(s) where it has to be applied (e.g., Practitioner vs PractitionerRole). The mappings and obligations for these details have been removed from the profile to avoid unintentional placement of these requirements until further pCHDCF data modelling for care team details is complete. Reviewers are encouraged to provide feedback on the potential impact of applying a 'no-error' obligation on this element for clients. 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 v2: PRT-15, STF-10, ROL-12 rim: ./telecom servd: ./ContactPoints
address	Σ	0..*	Address	There are no (further) constraints on this element Element id Practitioner.address Short description Address(es) of the practitioner that are not role specific (typically home address) Definition Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent. Requirements 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. Comments 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). Data type Address Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: XAD rim: AD servd: Address v2: ORC-24, STF-11, ROL-11, PRT-14 rim: ./addr servd: ./Addresses
gender	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Practitioner.gender Short description male \| female \| other \| unknown Definition Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes. Requirements Needed to address the person correctly. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The gender of a person used for administrative purposes. AdministrativeGender (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: STF-5 rim: ./administrativeGender servd: ./GenderCode
birthDate	Σ	0..1	date	There are no (further) constraints on this element Element id Practitioner.birthDate Short description The date on which the practitioner was born Definition The date of birth for the practitioner. Requirements Needed for identification. Data type date Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: STF-6 rim: ./birthTime servd: (not represented in ServD)
photo	I	0..*	Attachment	There are no (further) constraints on this element Element id Practitioner.photo Short description Image of the person Definition Image of the person. Requirements Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too. Comments 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". Data type Attachment Constraints 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()` Mappings rim: n/a v2: ED/RP rim: ED rim: ./subjectOf/ObservationEvent[code="photo"]/value servd: ./ImageURI (only supports the URI reference)
qualification		0..*	BackboneElement	There are no (further) constraints on this element Element id Practitioner.qualification Short description Certification, licenses, or training pertaining to the provision of care Definition The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality. 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 v2: CER? rim: .playingEntity.playingRole[classCode=QUAL].code servd: ./Qualifications
id		0..1	string	There are no (further) constraints on this element Element id Practitioner.qualification.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 Practitioner.qualification.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 Practitioner.qualification.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
identifier		0..*	Identifier	There are no (further) constraints on this element Element id Practitioner.qualification.identifier Short description An identifier for this qualification for the practitioner Definition An identifier that applies to this person's qualification in this role. Requirements Often, specific identities are assigned for the qualification. 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 rim: .playingEntity.playingRole[classCode=QUAL].id
code		1..1	CodeableConcept	There are no (further) constraints on this element Element id Practitioner.qualification.code Short description Coded representation of the qualification Definition Coded representation of the qualification. 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 qualification the practitioner has to provide a service. v2.0360.2.7 (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 rim: .playingEntity.playingRole[classCode=QUAL].code servd: ./Qualifications.Value
period	I	0..1	Period	There are no (further) constraints on this element Element id Practitioner.qualification.period Short description Period during which the qualification is valid Definition Period during which the qualification is valid. Requirements Qualifications are often for a limited period of time, and can be revoked. 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: .playingEntity.playingRole[classCode=QUAL].effectiveTime servd: ./Qualifications.StartDate and ./Qualifications.EndDate
issuer	I	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Practitioner.qualification.issuer Short description Organization that regulates and issues the qualification Definition Organization that regulates and issues the qualification. 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: .playingEntity.playingRole[classCode=QUAL].scoper
communication		0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Practitioner.communication Short description A language the practitioner can use in patient communication Definition A language the practitioner can use in patient communication. Requirements Knowing which language a practitioner speaks can help in facilitating communication with patients. Comments The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Data type CodeableConcept 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 v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: PID-15, NK1-20, LAN-2 rim: ./languageCommunication servd: ./Languages.LanguageSpokenCode

Obligations

Obligations are a new (and evolving) mechanism in FHIR to provide a consistent and machine processable way for profiles to define their expectations for system behaviors.

Earlier versions of the profiles exposed an initial set of obligations to garner feedback from the community on their use in Core+ profiles.

Obligations have been temporarily removed in this version to allow for further refinement of the approach against the Core Data for Interoperability (CACDI), which is now in development.

Terminology

This version of the guide is based on the early content development of the pan-Canadian Health Data Content Framework (pCHDCF). The pCHDCF is beginning to introduce recommended terminology for select concepts.

Terminology for CA Core+ Practitioner Profile has not been implemented in this release.

Mappings to pCHDCF

Draft Data Content Standard Element (As of 2024-06-18)	Draft Data Content Standard Element Definition (As of 2024-06-18)	FHIR Profile Element	Additional Notes
Provider National Unique Identifier	The registration number, or suitable alternative, that uniquely identifies a provider who may register in more than one province or territory.	Practitioner.identifier.value + Practitioner.identifier.system + Practitioner.identifier.type	This is a placeholder concept that has yet to be developed. pCHDCF modelling for care team concepts (including provider identifiers) is still underway. The requirements to support certain types of identifiers (e.g., province/territory registration identifiers) across all use cases and decisions on whether the identifier requirements should apply to both Practitioner and PractitionerRole are still undefined. Furthermore, the ways that these identifiers will be differentiated for conformance testing purposes is still undefined (see comment on identifier.type). For this reason, slice modelling and application of obligations towards certain identifiers is not currently expressed in this profile. The profile will continue to evolve as care team details undergo data modelling in the pCHDCF.
Provider Provincial/Territorial Registration Number	The registration number, or suitable alternative, that uniquely identifies a provider in a particular jurisdiction. Assigned by the submitting jurisdiction for administrative purposes.	Practitioner.identifier.value + Practitioner.identifier.system + Practitioner.identifier.type	This has been mapped as an identifier to account for the current broad definition that could be used administratively. Further narrowing of this concept towards medical licensure could result in expectations applied to Practitioner.qualification - Further feedback is requested to weigh in on the impact of duplicating license details as both identifiers and qualifications. pCHDCF modelling for care team concepts (including provider identifiers) is still underway. The requirements to support certain types of identifiers (e.g., province/territory registration identifiers) across all use cases and decisions on whether the identifier requirements should apply to both Practitioner and PractitionerRole are still undefined. Furthermore, the ways that these identifiers will be differentiated for conformance testing purposes is still undefined (see comment on identifier.type). For this reason, slice modelling and application of obligations towards certain identifiers is not currently expressed in this profile. The profile will continue to evolve as care team details undergo data modelling in the pCHDCF.
Provider Registration Province/Territory	The Canadian province or territory of registration, based on the jurisdiction or organization that submits provider data.	N/A*	*Likely a candidate for use case specific requirements (e.g., Practitioner.identifier.assigner for registry related use cases/actors) - Further feedback is requested on whether this expectation is appropriate for application on the general Practitioner profile
Provider Concurrent Registration Province/Territory	Any other Canadian province or territory that a provider is licensed in (for the same profession) at the time of registration or renewal.	N/A*	*Likely a candidate for use case specific requirements (e.g., Practitioner.identifier.assigner for registry related use cases/actors) - Further feedback is requested on whether this expectation is appropriate for application on the general Practitioner profile
Provider Concurrent Registration Country	Any other country that a provider is licensed in (for the same profession) at the time of registration or renewal.	N/A*	*Likely a candidate for a use case specific requirements (e.g., Practitioner.identifier.assigner.address for registry related use cases/actors) - Further feedback is requested on whether this expectation is appropriate for application on the general Practitioner profile
Provider Registration Status	The class of licence/registration issued to a provider by a regulatory body or other professional association at the time of registration or renewal.	N/A*	*Likely a candidate for use case specific requirements (e.g., Practitioner.identifier.extension:registrationdetails for registry related use cases/actors) - Further feedback is requested on whether this expectation is appropriate for application on the general Practitioner profile
Provider Registration Date	The month/year in which the provider registered (or renewed) with a Canadian provincial/territorial health care provider regulatory body or professional association.	N/A*	*Likely a candidate for use case specific requirements (e.g., Practitioner.identifier.extension:registrationdetails for registry related use cases/actors) - Further feedback is requested on whether this expectation is appropriate for application on the general Practitioner profile
Provider Provincial/Territorial Billing Number	The unique number assigned to a provider by a jurisdiction that allows the calculation and direct payment for claims submitted under the number.	Practitioner.identifier.value + Practitioner.identifier.system + Practitioner.identifier.type	*pCHDCF modelling for care team concepts (including provider identifiers) is still underway. The requirements to support certain types of identifiers (e.g., province/territory registration identifiers) across all use cases and decisions on whether the identifier requirements should apply to both Practitioner and PractitionerRole are still undefined. Furthermore, the ways that these identifiers will be differentiated for conformance testing purposes is still undefined (see comment on identifier.type). For this reason, slice modelling and application of obligations towards certain identifiers is not currently expressed in this profile. The profile will continue to evolve as care team details undergo data modelling in the pCHDCF.
Provider Billing Province/Territory	The jurisdiction issuing the provider's billing number.	N/A*	*Likely a candidate for use case specific requirements (e.g., Practitioner.identifier.assigner for registry related use cases/actors) - Further feedback is requested on whether this expectation is appropriate for application on the general Practitioner profile
Provider Last Name	The last name of the provider.	Practitioner.name.family
Provider First Name	The first name of the provider.	Practitioner.name.given
Provider Phone Number	The provider's phone number.	Practitioner.telecom.value* + Practitioner.telecom.system*	*Although the Provider Phone Number concept is expressed in the pCHDCF materials, the current definition does not distinctly identify the resource target(s) where it has to be applied (e.g., Practitioner vs PractitionerRole). The mappings and obligations for these details have been removed from the profile to avoid unintentional placement of these requirements until further pCHDCF data modelling for care team details is complete.
Provider Email	The provider's email address.	Practitioner.telecom.value* + Practitioner.telecom.system*	*Although the Provider Email concept is expressed in the pCHDCF materials, the current definition does not distinctly identify the resource target(s) where it has to be applied (e.g., Practitioner vs PractitionerRole). The mappings and obligations for these details have been removed from the profile to avoid unintentional placement of these requirements until further pCHDCF data modelling for care team details is complete.