Notice
- Important: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
- This Implementation Guide is currently in Draft and SHOULD NOT be used for development or active implementation without express direction from the NHS England Genomics Unit.
Genomics-PractitionerRole
PractitionerRole resources SHOULD be used where information about both a practitioner and their role within a specific organization is required, e.g. as the ServiceRequest.requestor.
References to Practitioner and Organization resources SHOULD only be made via identifier, rather than appending Practitioner and Organization resources to test order bundles. Issues with referencing via identifier SHOULD be reported to the NHS England Genomics Unit for investigation.
Profile url | FHIR Module | Normative Status |
---|---|---|
https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole | UKCore | trial-use |
UKCorePractitionerRole (PractitionerRole) | I | PractitionerRole | |
id | Σ | 0..1 | string |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | 0..1 | Narrative | |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
modifierExtension | ?! I | 0..* | Extension |
identifier | Σ | 0..* | Identifier |
active | S Σ | 0..1 | boolean |
period | S Σ I | 0..1 | Period |
practitioner | S Σ I | 0..1 | Reference(Practitioner) |
organization | S Σ I | 0..1 | Reference(Organization) |
code | Σ | 0..* | CodeableConcept |
specialty | S Σ | 0..* | CodeableConceptBinding |
location | S Σ I | 0..* | Reference(Location) |
healthcareService | I | 0..* | Reference(HealthcareService) |
telecom | S Σ I | 0..* | ContactPoint |
availableTime | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
daysOfWeek | 0..* | codeBinding | |
allDay | 0..1 | boolean | |
availableStartTime | 0..1 | time | |
availableEndTime | 0..1 | time | |
notAvailable | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
description | 1..1 | string | |
during | I | 0..1 | Period |
availabilityExceptions | 0..1 | string | |
endpoint | I | 0..* | Reference(Endpoint) |
Differential from PractitionerRole
UKCorePractitionerRole (PractitionerRole) | I | PractitionerRole | |
id | Σ | 0..1 | string |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | 0..1 | Narrative | |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
modifierExtension | ?! I | 0..* | Extension |
identifier | Σ | 0..* | Identifier |
active | S Σ | 0..1 | boolean |
period | S Σ I | 0..1 | Period |
practitioner | S Σ I | 0..1 | Reference(Practitioner) |
organization | S Σ I | 0..1 | Reference(Organization) |
code | Σ | 0..* | CodeableConcept |
specialty | S Σ | 0..* | CodeableConceptBinding |
location | S Σ I | 0..* | Reference(Location) |
healthcareService | I | 0..* | Reference(HealthcareService) |
telecom | S Σ I | 0..* | ContactPoint |
availableTime | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
daysOfWeek | 0..* | codeBinding | |
allDay | 0..1 | boolean | |
availableStartTime | 0..1 | time | |
availableEndTime | 0..1 | time | |
notAvailable | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
description | 1..1 | string | |
during | I | 0..1 | Period |
availabilityExceptions | 0..1 | string | |
endpoint | I | 0..* | Reference(Endpoint) |
PractitionerRole | |
Definition | A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time. |
Cardinality | 0...* |
Invariants |
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Mappings |
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PractitionerRole.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | string |
Summary | True |
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. |
PractitionerRole.meta | |
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. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
Invariants |
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Mappings |
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PractitionerRole.implicitRules | |
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. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
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. |
Invariants |
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Mappings |
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PractitionerRole.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. |
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). |
Invariants |
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Mappings |
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PractitionerRole.text | |
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. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
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. |
Invariants |
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Mappings |
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PractitionerRole.contained | |
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. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
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. |
Mappings |
|
PractitionerRole.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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PractitionerRole.modifierExtension | |
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). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
|
Mappings |
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PractitionerRole.identifier | |
Definition | Business Identifiers that are specific to a role/location. |
Cardinality | 0...* |
Type | Identifier |
Summary | True |
Requirements | Often, specific identities are assigned for the agent. |
Invariants |
|
Mappings |
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PractitionerRole.active | |
Definition | Whether this practitioner role record is in active use. |
Cardinality | 0...1 |
Type | boolean |
Must Support | True |
Summary | True |
Requirements | Need to be able to mark a practitioner role record as not to be used because it was created in error, or otherwise no longer in active use. |
Comments | If this value is false, you may refer to the period to see when the role was in active use. If there is no period specified, no inference can be made about when it was active. |
Invariants |
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Mappings |
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PractitionerRole.period | |
Definition | The period during which the person is authorized to act as a practitioner in these role(s) for the organization. |
Cardinality | 0...1 |
Type | Period |
Must Support | True |
Summary | True |
Requirements | Even after the agencies is revoked, the fact that it existed must still be recorded. |
Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. |
Invariants |
|
Mappings |
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PractitionerRole.practitioner | |
Definition | Practitioner that is able to provide the defined services for the organization. |
Cardinality | 0...1 |
Type | Reference(Practitioner) |
Must Support | True |
Summary | True |
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. |
Invariants |
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Mappings |
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PractitionerRole.organization | |
Definition | The organization where the Practitioner performs the roles associated. |
Cardinality | 0...1 |
Type | Reference(Organization) |
Must Support | True |
Summary | True |
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. |
Invariants |
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Mappings |
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PractitionerRole.code | |
Definition | Roles which this practitioner is authorized to perform for the organization. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | The role a person plays representing an organization. |
Summary | True |
Requirements | Need to know what authority the practitioner has - what can they do? |
Comments | A person may have more than one role. |
Invariants |
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Mappings |
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PractitionerRole.specialty | |
Definition | Specific specialty of the practitioner. |
Cardinality | 0...* |
Type | CodeableConcept |
Binding | Specific specialty associated with the agency. |
Must Support | True |
Summary | True |
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. |
Invariants |
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Mappings |
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PractitionerRole.location | |
Definition | The location(s) at which this practitioner provides care. |
Cardinality | 0...* |
Type | Reference(Location) |
Must Support | True |
Summary | True |
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. |
Invariants |
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Mappings |
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PractitionerRole.healthcareService | |
Definition | The list of healthcare services that this worker provides for this role's Organization/Location(s). |
Cardinality | 0...* |
Type | Reference(HealthcareService) |
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. |
Invariants |
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Mappings |
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PractitionerRole.telecom | |
Definition | Contact details that are specific to the role/location/service. |
Cardinality | 0...* |
Type | ContactPoint |
Must Support | True |
Summary | True |
Requirements | Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these. |
Invariants |
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Mappings |
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PractitionerRole.availableTime | |
Definition | A collection of times the practitioner is available or performing this role at the location and/or healthcareservice. |
Cardinality | 0...* |
Type | BackboneElement |
Comments | More detailed availability information may be provided in associated Schedule/Slot resources. |
Invariants |
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Mappings |
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PractitionerRole.availableTime.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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PractitionerRole.availableTime.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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PractitionerRole.availableTime.modifierExtension | |
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). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
Invariants |
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Mappings |
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PractitionerRole.availableTime.daysOfWeek | |
Definition | Indicates which days of the week are available between the start and end Times. |
Cardinality | 0...* |
Type | code |
Binding | The days of the week. |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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PractitionerRole.availableTime.allDay | |
Definition | Is this always available? (hence times are irrelevant) e.g. 24 hour service. |
Cardinality | 0...1 |
Type | boolean |
Invariants |
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Mappings |
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PractitionerRole.availableTime.availableStartTime | |
Definition | The opening time of day. Note: If the AllDay flag is set, then this time is ignored. |
Cardinality | 0...1 |
Type | time |
Comments | The timezone is expected to be for where this HealthcareService is provided at. |
Invariants |
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Mappings |
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PractitionerRole.availableTime.availableEndTime | |
Definition | The closing time of day. Note: If the AllDay flag is set, then this time is ignored. |
Cardinality | 0...1 |
Type | time |
Comments | The timezone is expected to be for where this HealthcareService is provided at. |
Invariants |
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Mappings |
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PractitionerRole.notAvailable | |
Definition | The practitioner is not available or performing this role during this period of time due to the provided reason. |
Cardinality | 0...* |
Type | BackboneElement |
Invariants |
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Mappings |
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PractitionerRole.notAvailable.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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PractitionerRole.notAvailable.extension | |
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. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
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. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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PractitionerRole.notAvailable.modifierExtension | |
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). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
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. |
Invariants |
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Mappings |
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PractitionerRole.notAvailable.description | |
Definition | The reason that can be presented to the user as to why this time is not available. |
Cardinality | 1...1 |
Type | string |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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PractitionerRole.notAvailable.during | |
Definition | Service is not available (seasonally or for a public holiday) from this date. |
Cardinality | 0...1 |
Type | Period |
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. |
Invariants |
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Mappings |
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PractitionerRole.availabilityExceptions | |
Definition | A description of site availability exceptions, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as details in the available Times and not available Times. |
Cardinality | 0...1 |
Type | string |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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PractitionerRole.endpoint | |
Definition | Technical endpoints providing access to services operated for the practitioner with this role. |
Cardinality | 0...* |
Type | Reference(Endpoint) |
Requirements | Organizations have multiple systems that provide various services and ,ay also be different for practitioners too. So the endpoint satisfies the need to be able to define the technical connection details for how to connect to them, and for what purpose. |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
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Mappings |
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FHIR | MDS | HL7v2 |
---|---|---|
PractitionerRole.practitioner | Requestor - Full name, Requestor - Professional registration number, Requestor - Professional registration number type, Additional contact - Full name, Additional contact - Professional registration number, Additional contact - Professional registration number type, Patient - GP full name, Patient - GP GMC number, Previous genomic report - Report performer full name, Previous genomic report - Original requester full name, Previous non genomic report - Report performer full name, Previous non genomic report - Original requester full name | ORC-12, ORC-12.1, ORC-12.9, PD1-4.2 and PD1-4.3, PD1-4.1, OBX-16, ORC-12 |
PractitionerRole.code | Requestor - Job Title, Additional contact - Job Title | CTD-1 |
PractitionerRole.specialty | Requestor - Current Specialty, Requestor - Department name, Additional contact - Current Specialty, Additional contact - Department name | Additional CTD-1 segments |
PractitionerRole.telecom | Requestor - Phone, Requestor - Email address, Requestor - Genomic report delivery method, Requestor - Central email for address and reporting (many), Additional contact - Phone, Additional contact - Email address, Additional contact - Genomic report delivery method, Additional contact - Central email for address and reporting (many) | ORC-14 |
PractitionerRole.organization | Requestor - Organization name, Requestor - Organization address, Requestor - Organization ODS code, Additional contact - Organization name, address and ODS code, Additional contact - Organization address, Additional contact - Organization ODS code, Patient - GP Practice ODS Code, Previous genomic report - Report performer organisation ODS code, Previous genomic report - Original requester organisation ODS code, Previous non genomic report - Report performer organisation ODS code, Previous non genomic report - Original requester organisation ODS code | ORC-21, ORC-22, ORC-21.10, OBX-23.10 |
PractitionerRole.healthcareService | PLCM activity - ODS code of the laboratory site delivering requested test, PLCM activity - Commissioned service category code | Additional CTD-1 segments |
Constraint Profiles
Profiles indicating preferred element cardinality for use in Genomics, not to be used for validation
name | profile |
---|---|
NHSDigital_PractitionerRole_Genomics | https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole-Genomics |
Additional Guidance
practitioner
SHALL be present. Users SHOULD reference practitioners using an appropriate naming system within the NHS (defined within the NHS England IG. Display name MAY be included to aid readability and verification of included identifiers.
"practitioner": { "identifier": { "system": "https://fhir.nhs.uk/Id/sds-user-id", "value": "9999999999" }, "display": "Dr. Gene Smith" },
organization
SHALL be present. Users SHOULD reference organizations using an ODS code. Display name MAY be included to aid readability and verification of included identifiers. Requester ODS codes SHOULD use the lowest level site code rather than trust code (most granular code available) where possible, to aid contact retrieval.
"organization": { "identifier": { "system": "https://fhir.nhs.uk/Id/ods-organization-code", "value": "RGT01" }, "display": "Addenbrooke's Hospital" },
specialty
The specialty field SHOULD be used to record department for the requesting clinician, issues with the use of this field, including issues with the bound UK Core ValueSet not representing certain departments SHOULD be reported to the NHS England Genomics Unit
"specialty": [ { "coding": [ { "system": "https://fhir.hl7.org.uk/CodeSystem/UKCore-PracticeSettingCode", "code": "120", "display": "Ear Nose and Throat" } ] } ],
telecom
The telecom field SHOULD be used to record contact details for the practitioner. For central mailboxes, e.g. those used for providing reports back to the requester, these SHOULD be marked with an appropriate 'contactpoint-comment' extension. Additionally, where are there multiple Practitioners involved in providing care, the contact details for each Practitioners for that location (or service) SHOULD be specified.
"telecom": [ { "system": "phone", "value": "01223586638" }, { "system": "email", "value": "gene.smith@nhs.net" }, { "system": "email", "value": "Add-tr.entsecretaries@nhs.net", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/contactpoint-comment", "valueString": "reporting" } ] } ]