FHIR Artifacts > Structure Definition: Communication Profile

Structure Definition: Communication Profile

Canonical URL:http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Communication

Simplifier project page:

Command 'link' could not render: File was not found for ca-on-eReferral-profile-Communication:name

Derived from: Communication(R4)

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work

Differential View

versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ0..1uri
valueS Σ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
instantiatesCanonicalΣ0..1canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)
instantiatesUriΣ0..1uri
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
partOfΣ I0..1Reference(Resource)
inResponseToS I0..*Reference(Communication)
statusS Σ ?!1..1codeBindingFixed Value
statusReasonΣ0..1CodeableConcept
systemS Σ1..1uriFixed Value
versionΣ0..1string
codeS Σ1..1code
displayS Σ1..1string
userSelectedΣ0..1boolean
textΣ0..1string
priorityΣ0..1codeBinding
medium0..1CodeableConcept
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
systemΣ0..1uri
versionΣ0..1string
codeΣ0..0code
displayΣ0..1string
userSelectedΣ0..0boolean
textΣ0..1string
aboutI0..1Reference(Resource)
encounterΣ I0..1Reference(Encounter)
sentS0..1dateTime
received0..1dateTime
recipientI0..*Reference(Organization | Patient | Practitioner | PractitionerRole | HealthcareService)
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
reasonCodeΣ0..1CodeableConcept
reasonReferenceΣ I0..1Reference(Condition | Observation | DiagnosticReport | DocumentReference)
contentStringstring
contentAttachmentAttachment
authorStringstring
timeΣ0..1dateTime
textΣ1..1markdown

Hybrid View

versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ0..1uri
valueS Σ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
instantiatesCanonicalΣ0..1canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)
instantiatesUriΣ0..1uri
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
partOfΣ I0..1Reference(Resource)
inResponseToS I0..*Reference(Communication)
statusS Σ ?!1..1codeBindingFixed Value
statusReasonΣ0..1CodeableConcept
systemS Σ1..1uriFixed Value
versionΣ0..1string
codeS Σ1..1code
displayS Σ1..1string
userSelectedΣ0..1boolean
textΣ0..1string
priorityΣ0..1codeBinding
medium0..1CodeableConcept
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
systemΣ0..1uri
versionΣ0..1string
codeΣ0..0code
displayΣ0..1string
userSelectedΣ0..0boolean
textΣ0..1string
aboutI0..1Reference(Resource)
encounterΣ I0..1Reference(Encounter)
sentS0..1dateTime
received0..1dateTime
recipientI0..*Reference(Organization | Patient | Practitioner | PractitionerRole | HealthcareService)
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
reasonCodeΣ0..1CodeableConcept
reasonReferenceΣ I0..1Reference(Condition | Observation | DiagnosticReport | DocumentReference)
contentStringstring
contentAttachmentAttachment
authorStringstring
timeΣ0..1dateTime
textΣ1..1markdown

Snapshot View

versionIdΣ0..1id
lastUpdatedΣ0..1instant
sourceΣ0..1uri
profileS Σ1..*canonical(StructureDefinition)
securityΣ0..*CodingBinding
tagΣ0..*Coding
useΣ ?!0..1codeBinding
typeΣ0..1CodeableConceptBinding
systemS Σ0..1uri
valueS Σ0..1string
periodΣ I0..1Period
assignerΣ I0..1Reference(Organization)
instantiatesCanonicalΣ0..1canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)
instantiatesUriΣ0..1uri
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
partOfΣ I0..1Reference(Resource)
inResponseToS I0..*Reference(Communication)
statusS Σ ?!1..1codeBindingFixed Value
statusReasonΣ0..1CodeableConcept
systemS Σ1..1uriFixed Value
versionΣ0..1string
codeS Σ1..1code
displayS Σ1..1string
userSelectedΣ0..1boolean
textΣ0..1string
priorityΣ0..1codeBinding
medium0..1CodeableConcept
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
systemΣ0..1uri
versionΣ0..1string
codeΣ0..0code
displayΣ0..1string
userSelectedΣ0..0boolean
textΣ0..1string
aboutI0..1Reference(Resource)
encounterΣ I0..1Reference(Encounter)
sentS0..1dateTime
received0..1dateTime
recipientI0..*Reference(Organization | Patient | Practitioner | PractitionerRole | HealthcareService)
referenceS Σ I1..1string
typeΣ0..1uriBinding
identifierΣ0..1Identifier
displayΣ0..1string
reasonCodeΣ0..1CodeableConcept
reasonReferenceΣ I0..1Reference(Condition | Observation | DiagnosticReport | DocumentReference)
contentStringstring
contentAttachmentAttachment
authorStringstring
timeΣ0..1dateTime
textΣ1..1markdown

Table View

Communication..
Communication.meta1..
Communication.meta.profile1..
Communication.identifier..
Communication.identifier.system..
Communication.identifier.value..
Communication.instantiatesCanonical..1
Communication.instantiatesUri..1
Communication.basedOnReference(ServiceRequest)..
Communication.basedOn.reference1..
Communication.partOf..1
Communication.inResponseTo..
Communication.status..
Communication.category..
Communication.category.coding..
Communication.category.coding.system1..
Communication.category.coding.code1..
Communication.category.coding.display1..
Communication.priority..
Communication.medium..1
Communication.subjectReference(Patient)..
Communication.subject.reference1..
Communication.topic..
Communication.topic.coding..
Communication.topic.coding.code..0
Communication.topic.coding.userSelected..0
Communication.about..1
Communication.sent..
Communication.recipientReference(Organization | Patient | Practitioner | PractitionerRole | HealthcareService)..
Communication.senderReference(PractitionerRole)..
Communication.sender.reference1..
Communication.reasonCode..1
Communication.reasonReference..1
Communication.payload..
Communication.payload.content[x]string, Attachment..
Communication.note..
Communication.note.author[x]string..


JSON View

{
    "resourceType": "StructureDefinition",
    "id": "ca-on-eReferral-profile-Communication",
    "url": "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Communication",
    "version": "1.0.0",
    "name": "EReferralCommunication",
    "title": "Communication",
    "status": "draft",
    "description": "Communication resource is used to achieve the bi-directional communication between two systems. The Communication resource can be used to ask questions regarding a referral, request a referral be updated with missing information, or request additional information not covered by the specific referral dataset.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Communication",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Communication",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Communication.meta",
                "path": "Communication.meta",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.meta.profile",
                "path": "Communication.meta.profile",
                "comment": "#### **_` FOR eREFERRAL USAGE: The meta.profile = http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Communication|1.0.0 `_**\n\nIt is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set.",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.identifier",
                "path": "Communication.identifier",
                "mustSupport": true
            },
            {
                "id": "Communication.identifier.system",
                "path": "Communication.identifier.system",
                "mustSupport": true
            },
            {
                "id": "Communication.identifier.value",
                "path": "Communication.identifier.value",
                "mustSupport": true
            },
            {
                "id": "Communication.instantiatesCanonical",
                "path": "Communication.instantiatesCanonical",
                "max": "1"
            },
            {
                "id": "Communication.instantiatesUri",
                "path": "Communication.instantiatesUri",
                "max": "1"
            },
            {
                "id": "Communication.basedOn",
                "path": "Communication.basedOn",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-ServiceRequest"
                        ],
                        "aggregation":  [
                            "referenced"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Communication.basedOn.reference",
                "path": "Communication.basedOn.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.partOf",
                "path": "Communication.partOf",
                "max": "1"
            },
            {
                "id": "Communication.inResponseTo",
                "path": "Communication.inResponseTo",
                "mustSupport": true
            },
            {
                "id": "Communication.status",
                "path": "Communication.status",
                "fixedCode": "completed",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://hl7.org/fhir/ValueSet/event-status"
                }
            },
            {
                "id": "Communication.category",
                "path": "Communication.category",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://ehealthontario.ca/fhir/ValueSet/communication-category"
                }
            },
            {
                "id": "Communication.category.coding",
                "path": "Communication.category.coding",
                "mustSupport": true,
                "binding": {
                    "strength": "extensible",
                    "valueSet": "http://ehealthontario.ca/fhir/ValueSet/communication-category"
                }
            },
            {
                "id": "Communication.category.coding.system",
                "path": "Communication.category.coding.system",
                "min": 1,
                "fixedUri": "https://ehealthontario.ca/fhir/CodeSystem/communication-category",
                "mustSupport": true
            },
            {
                "id": "Communication.category.coding.code",
                "path": "Communication.category.coding.code",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.category.coding.display",
                "path": "Communication.category.coding.display",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.priority",
                "path": "Communication.priority",
                "binding": {
                    "strength": "required",
                    "valueSet": "http://hl7.org/fhir/ValueSet/request-priority"
                }
            },
            {
                "id": "Communication.medium",
                "path": "Communication.medium",
                "max": "1"
            },
            {
                "id": "Communication.subject",
                "path": "Communication.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Patient"
                        ],
                        "aggregation":  [
                            "referenced"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Communication.subject.reference",
                "path": "Communication.subject.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.topic.coding.code",
                "path": "Communication.topic.coding.code",
                "max": "0"
            },
            {
                "id": "Communication.topic.coding.userSelected",
                "path": "Communication.topic.coding.userSelected",
                "max": "0"
            },
            {
                "id": "Communication.about",
                "path": "Communication.about",
                "max": "1"
            },
            {
                "id": "Communication.sent",
                "path": "Communication.sent",
                "mustSupport": true
            },
            {
                "id": "Communication.recipient",
                "path": "Communication.recipient",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Organization",
                            "http://hl7.org/fhir/StructureDefinition/Patient",
                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
                            "http://hl7.org/fhir/StructureDefinition/HealthcareService"
                        ]
                    }
                ]
            },
            {
                "id": "Communication.sender",
                "path": "Communication.sender",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-PractitionerRole"
                        ],
                        "aggregation":  [
                            "referenced"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Communication.sender.reference",
                "path": "Communication.sender.reference",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.reasonCode",
                "path": "Communication.reasonCode",
                "max": "1"
            },
            {
                "id": "Communication.reasonReference",
                "path": "Communication.reasonReference",
                "max": "1"
            },
            {
                "id": "Communication.payload",
                "path": "Communication.payload",
                "mustSupport": true
            },
            {
                "id": "Communication.payload.content[x]",
                "path": "Communication.payload.content[x]",
                "type":  [
                    {
                        "code": "string"
                    },
                    {
                        "code": "Attachment"
                    }
                ]
            },
            {
                "id": "Communication.note.author[x]",
                "path": "Communication.note.author[x]",
                "type":  [
                    {
                        "code": "string"
                    }
                ]
            }
        ]
    }
}

Usage

The Communication Resource is used in this IG to provide bidirectional communication between two systems and their users. The Communication resource can be used to ask questions about a referral, to request information or to provide information.

Although the Communication resource has the ability to carry attachments as .payload.content, it SHALL NOT be used to attach .supportingInfo to a ServiceRequest. (Use the Document Reference resource for this purpose.)

Notes

.id

  • used to uniquely identify the resource
  • if a persistent identity for the resource is not available to use when constructing a message Bundle for transmission via Direct Messaging, a UUID SHOULD be used in this element (with a corresponding value in Bundle.entry.fullUrl)

.meta.profile

  • used to declare conformance to this profile
  • populate with a fixed value: `http://ehealthontario.ca/fhir/StructureDefinition/ca-on-eReferral-profile-Communication|1.0.0'

.basedOn

  • used to associate the Communication with the ServiceRequest
  • SHALL be populated with a reference to the ServiceRequest being performed
  • if the Communication is being transmitted via messaging, the referenced ServiceRequest resource SHALL be included in the message as a Bundle.entry
  • NOTE: this element will reference multiple ServiceRequests in situations where the Communication relates to a requisition vs a single request, see business rules for more information

.inResponseTo

  • indicates that the Communication is a response to another Communication and creates an association with the prior
  • populate with Communication.id from the Communication being responded to
  • where a Communication is part of a converstation, implementers SHOULD include both the Communication in MessageHeader.focus and the one it is .inResponseTo as Bundle entries to allow them to be correctly associated with one another on the receiving system (others further up the chain MAY be omitted on the assumption that any necessary associations between Communications have already been made)

.status

  • SHOULD be populated with the value "completed" when it is submitted via Direct Messaging

.category

  • used to indicate the category of Communication
  • use of values
    • "gen" when sending general communications
    • "plan" when sending plan of care on service completion
    • "rfi" when sending via Direct Messaging "add-rfi" event

.priority

  • MAY be used to indicate the priority of the Communication
  • typically populated with "routine"

.subject

  • used to associate a Communication with the patient is about
  • SHOULD NOT be populated for general Communications that are about the ServiceRequest, not the patient
  • if populated, it SHALL reference the Patient in ServiceRequest.subject (e.g.: where the Communication.category is "plan")

.topic.text

  • MAY be used to describe the purpose or content of the Communication (coding is not supported)

.sent

  • populate with the time when the Communication was sent

.received

  • MAY be populated by the receiver with the time the Communication was received
  • SHALL NOT be populated in the Communication in MessageHeader.focus on the "add-communication" event

.recipient

  • typically not used (conceptually the ServiceRequest is the recipient)

.sender

  • used to identify the person who sent the messaging (e.g.: when rendering a conversation between individuals for display in the receiving system)
  • SHALL be populated with a reference to the PractionerRole of the person sending the communication
  • if the Communication is being transmitted via messaging, the referenced PractionerRole resource SHALL be included in the message as a Bundle.entry

.payload.content

  • the content of the Communication

  • business rules:

    • there SHALL NOT be more than one instance of .payload.contentString per Communication instance
    • there MAY be multiple instances of .payload.contentAttachment per Communication instance
  • expected use:

    • when sendng JUST a text message, send a single .payload.contentString
    • when sendng JUST an attachment, send a single .payload.contentAttachment
    • when sending a text message with attachments, send multiple instances of .payload
      • one with the message (.payload.contentString)
      • one for each attachment (.payload.contentAttachment)

    For eConsult:

    • use the above business rules and expected use for sending communication between referrers and receipients
    • for adding notes use payload.contentAttachment

NOTE: although sending base64 encoded .payload.contentAttachment.data is supported, implementers of Direct Messaging SHOULD make binary attachments be made available to retrieve from a server using a .payload.contentAttachment.url to reduce message sizes