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Bookings and Referrals into UEC (Application 1)
Application Version | Minimum Core Version | Minimum Guide Version | Minimum API Spec Version |
---|---|---|---|
Application 1 v1.0.7 | v1.0.x | v1.8.2 | v1.0.0 |
Use Cases Supported
This Application supports the use of the following use cases:
Use Case | Name | Code |
---|---|---|
111 (telephony) to ED (Emergency Department) | 111 to ED | A1T1 |
111 (telephony) to UTC (Urgent Treatment Centre) | 111 to UTC | A1T2 |
IUC CAS (Integrated Urgent Care Clinical Assessment Service) to ED (Emergency Department) | IUC CAS to ED | A1T3 |
IUC CAS (Integrated Urgent Care Clinical Assessment Service) to UTC (Urgent Treatment Centre) | IUC CAS to UTC | A1T4 |
AST (999 Ambulance Service Trust) to ED (Emergency Department) | 999 to ED | A1T5 |
AST (999 Ambulance Service Trust) to UTC (Urgent Treatment Centre) | 999 to UTC | A1T6 |
111 (telephony) to SDEC (Same Day Emergency Care) | 111 to SDEC | A1T7 |
IUC CAS (Integrated Urgent Care Clinical Assessment Service) to SDEC (Same Day Emergency Care) | IUC CAS to SDEC | A1T8 |
AST (999 Ambulance Service Trust) to SDEC (Same Day Emergency Care) | 999 to SDEC | A1T9 |
note: for use cases where the sending system is 111 Online, please see Bookings and Referrals into UEC Application 2
Introduction
Overview
This page provides guidance for implementing the Booking and Referral Standard (BaRS) specifically for the use cases listed above. It should be used alongside the BaRS Core implementation guide and Payload Definitions when developing to the standard.
Data model endorsements
The referral information data model is based on user research with NHS 111 service providers, 999 Ambulance Service Trusts (AST) and clinical and administrative Emergency Department staff. We carried out this research in parallel with the Professional Records Standards Body (PRSB) who examined the wider brief of 'referrals from NHS 111 to any other care setting'.
We worked alongside PRSB to ensure data transferred from 111 to ED is clinically relevant and safe. PRSB have defined and endorsed an information model which works for both the senders (111) and receivers (ED) when referrals are made between the respective services. This endorsement provides the necessary confidence that solutions built to the standard will be both fit for purpose and safe.
For more information see Bookings and Referrals into UEC Application 1
Scope and Requirements
Scope Overview
This BaRS Application (Application 1) covers only use cases:
- 111 (telephony) to ED
- 111 (telephony) to UTC
- IUC CAS to ED
- IUC CAS to UTC
- AST to ED (Pathways only)
- AST to UTC (Pathways only)
- 111 to SDEC
- CAS to SDEC
- AST to SDEC (Pathways only)
The payloads and workflow have been designed to support these services. Other BaRS Applications offer scope for alternative use cases.
Functional Scope
Service Discovery
- Establishing a service to direct requests to is a mandatory step in the workflow
- There is no restriction on the service discovery tools used. Any are capable of being supported whether national or proprietary
- The service must be configured within the BaRS infrastructure (Endpoint Catalogue) before requests can be made
Slot Management
- Booking slots are the responsibility and ownership of Receivers to maintain and offer to Senders
- All slot requests must occur in real-time without caching by either Senders or Receivers
- The returned slots should contain sufficient information for Senders to know what they are booking i.e. have a clear 'type', indicate the role and/or gender of the individual performing on behalf of the service, within any given slot
Booking
- Allowing bookings for a service is a method of managing capacity
- A booking may indicate the exact time an individual can expect to be seen by or is expected to arrive at the service, as is traditionally understood when an 'appointment' is made. Alternatively, the booking timeframe could indicate a range through which the individual may be seen by the service
- The slot the booking is made against may also indicate the type of booking e.g. face-to-face or over the phone and the role of the person who will engage with the individual on behalf of the service
- Bookings are an administrative aspect of the workflow and should not contain clinically pertinent information
Referral
- A referral is a request for care on behalf of an individual from one service to another
- The referral can be sent without having to establish the capacity the service offers
- The referral will contain primarily clinical information, indicating the need of the individual and should state the anticipated action required by the Receiving service
- A referral can be made independent of booking but, where a booking is made as part of the same workflow, they must be linked
- Supporting information, other than the assessment, is expected to be included in a referral, if collected, including:
- new or existing safeguarding concerns
- locally held Special Patient Notes
- external information sources used during initial assessment prior to referral
- list of any services rejected prior to the Receiving service being selected, including reason for rejection
API-M
- All requests and response associated with BaRS must occur through the BaRS API Proxy
Constraints
- Supporting use of NHS Pathways and NHS Pathways Clinical Content Support (PaCCS) Clinical Decision Support Systems only
- All Service IDs in First of Type (FoT) will be those of Urgent and Emergency Care (UEC) Directory of Services (DoS)
- DoS 'attributes' for controlling Booking into services are to remain honoured (see "how does it work" section below for more information)
- No guidance provided on display of referral information beyond the Principles for rendering BaRS Payload.
- No additional guidance provided on Slot display for Booking
- Consent within BaRS will be for Direct-Care only
- Certificates for Receiving messages to use nhs.uk domains only.
- Receiving endpoints are to be internet facing.
- Limited Search Slot parameters for Booking - Schedule.actor:healthcareService, Start (range), (slot) status
- Clincial Constraints exist - See Hazard Log
- No element level 'updates' to requests. A new request must be generated to change information in a booking or referral request
Requirements
Service Discovery
- The service must support a unique identifier which the Sender extracts to engage in booking and referral workflows
Slot display
- The schedule and related slot(s) must contain the actual geographic location (e.g address) of the booking, rather than generic details of the location of the overall service provider.
- The slot must contain details of the start/end times of the available slots
- The available slot(s) must be capable of being retrieved from any booking Receiver, regardless of the relationship that the sending user’s organisation has with the receiving service
- Where there are no available slots, the booking Receiver must send an appropriate response to indicate this not merely reply with an empty response
- Where there are no available slots, the booking Sender must present an appropriate message to the end user
- The booking Receiver must return available slots without requiring to know the potential patient details
- Where the booking Receiver has a number of schedules available to fulfil a request (say, when 2 or more clinicians are delivering surgeries at the same site) they must return all of those slots as part of the initial response
- If provided, in addition to Healthcare Service, Schedule and Slot, the booking Sender must display Delivery Channel and Practitioner Role, Name and Gender
- Booking Receivers must not default the Delivery Channel value
- A booking Sender must not assume a booking Receiver will return requested _includes e.g. Location
- Booking Sender must handle a Slot response without non mandatory FHIR resources
- Booking Sender must handle a Slot response with FHIR resources not requested
Booking
- The booking Receiver must accept the booking request regardless of whether the patient is known to the service provider
- The booking Receiver must accept potential patients who do not have a national validated identifier e.g. NHS Number.
- Where a national identifier is included, it must be 'traced and verified', otherwise, the referral Sender must not include the national indentifier in the request
- Where the booking was not successful, the Receiver must send an appropriate response. See failure scenarios for more detail.
- Where the booking was not successful, the Sender must present an appropriate message to the end user. See failure scenarios for more detail.
- If included in the synchronous HTTP response, the booking Sender must make available the human readable identifier for the booking to the end user
- The booking Sender must send accompanying clinical information in a BaRS referral request
- The booking Sender must reference the booking in the BaRS referral request (where the booking is made first in the workflow)
- The booking Receiver must link the explicitly related booking and referral requests
- Update to amend a booking request is not supported. If a booking Sender wishes to change information in a request they must follow the re-book workflow
Cancel booking
- The booking Sender must be capable of cancelling any booking made by them, within the current consultation or after the consultation event
- The booking Sender must retrieve the booking to be cancelled from the booking Receiver prior to cancellation to ensure they are working with the most up to date version and it has not already been completed
- The booking Sender must provide visible confirmation to the end user of the status returned by the booking Receiver, indicating whether the original booking was successfully cancelled or not
- If the cancellation fails the booking Receiver must respond with the most appropriately aligned error
- The booking Receiver must store all previous versions of the booking, including cancellations
- The booking Receiver must not be required to inform the patient of the cancellation of the booking. Business/clinical responsibility for informing the patient must remain with the booking Sender
- Any referral, sent as part of a booking, should be decoupled from the booking when cancelled and not be assumed to be a referral in its own right i.e. to ensure 'booking only' services are appropriately updated
Rebook
- The booking Sender must be capable of rebooking within the current consultation or after the consultation event
- If a callback occurs after the consultation has been completed, prior to attempting a rebook the patient should be reassessed
- The booking Sender must cancel the original booking prior to making the new booking, whether within the current consultation or after the consultation event
- The booking Sender must provide visible confirmation to the end user of the status returned by the Receiver, indicating whether the original booking was successfully cancelled and the new booking made
- The booking Receiver must not be required to inform the patient of the cancellation, incurred as part of the rebooking process. Business/clinical responsibility for informing the patient must remain with the booking Sender
- The new booking must not link to any originally linked referral, rather a new referral must be made and the original 'revoked'
Booking outside assessment outcome timeframe
- The booking Sender must allow clinical users to book outside the assessment outcome timeframe
- The booking Sender must present a notification to non-clinical users and prompt to seek clinical approval to book outside the assessment outcome timeframe
- The booking Sender must store sufficient audit information to show where a patient has been booked outside their assessment outcome timeframe
Referral requires booking (Require-Booking services)
- The booking Sender must stop the end users from making a referral if no booking has been made when the “RequireBooking” service attribute is present against the DoS service
- The booking Sender must present an appropriate warning message to the end user, indicating the specific service requirements
- The booking Sender must allow the referral to be sent when a booking is made
- The end user must be allowed to select an alternative service, if they are unable to proceed with "RequireBooking" service
Referral
- The referral Receiver must accept the referral request regardless of whether the patient is known to the service provider
- The referral Receiver must accept potential patients who do not have a national validated identifier e.g. NHS Number.
- Where a national identifier is included, it must be 'traced and verified', otherwise, the referral Sender must not include in the request
- Any new or existing safeguarding concern, recorded as part of the assessment, must be included in the referral Sender's request
- The referral Receiver must clearly identify any included safeguarding concern to the end user
- The referral Receiver must accurately represent information made by the Sender to the end user
- The referral Sender must make available the human readable identifier for the referral, included in the HTTP synchronous response, to the end user
- Where the referral was not successful, the Receiver must send an appropriate response. See failure scenarios for more detail.
- Where the referral was not successful, the Sender must present an appropriate message to the end user. See failure scenarios for more detail.
- The referral Sender must include reference to any accompanying BaRS booking related to the referral
- The referral Sender's request must be referenced in the BaRS booking request (where the referral is made first in the workflow)
- The referral Receiver must link the explicitly related booking and referral requests
- Update to amend a referral request is not supported. If a referral Sender wishes to change information in a request they must follow the re-refer workflow
Cancel referral
- The referral Sender must be capable of cancelling any referral made by them, within the current consultation or after the consultation event
- The referral Sender must retrieve the referral to be cancelled from the referral Receiver prior to cancellation to ensure they are working with the most up-to date version and it has not already been completed
- The referral Sender must provide visible confirmation to the end user of the status returned by the referral Receiver, i.e. whether the original referral was successfully cancelled or not
- If the update fails the referral Receiver must respond with the most appropriately aligned error
- The referral Receiver must store all previous versions of the referral
- The referral Receiver must not be required to inform the patient of the cancellation of the referral. Business/clinical responsibility for informing the patient must remain with the referral Sender
- Any booking, sent as part of a referral, should be decoupled from the referral when cancelled. It may be linked in any subsequent re-refer workflow
Re-refer
- The referral Sender must be capable of re-referring within the current consultation or after the consultation event
- If a callback occurs, after the consultation has been completed, prior to attempting a re-refer the patient should be reassessed
- The referral Sender should revoke the original referral prior to making a new re-referral, whether within the current consultation or after the consultation event
- The referral Sender must provide visible confirmation to the end user of the status returned by the Receiver, i.e. whether the original referral was successfully revoked and the new referral made
- The referral Receiver must not be required to inform the patient of the cancellation, incurred as part of the re-refer process. Business/clinical responsibility for informing the patient must remain with the referral Sender
Contacts
- A minimum of one contact (patient or third party) with a contact method (phone, email, etc.) of phone must be provided in booking and referral requests
- All contacts must have a rank associated with them
- There must be only one contact with a rank of 1
- All contacts must have at least one contact method (phone, email, etc.)
- All contact methods must have a rank
- There must be only one contact method with a rank of 1
- The contact ranked 1 and the contact method ranked 1 must be the primary callback for the request
Audit
- Sufficient information around any activity through the API and subsequent BaRS workflow must be persisted to aid support incidents and audit requirements
Error Handling
- Suppliers must adhere to the error handling guidance
Non Functional
- Suppliers must adhere to the non functional requirements
How does it work?
This section describes how the primary operations used in this Application works. This diagram illustrates the workflow and interactions of a referral request and booking process:
To support the workflows for this Application of the standard the operations that need to be supported are:
Make a Referral
Making a referral for this Application follows the standard pattern for BaRS composite operations.
The message definition that defines this payload for this Application is: BARS Message Definition ServiceRequest - Request Referral
In addition to that the specific workflow parameters that are required are as follows:
Interaction | Method | Payload Focus | Status Required (MessageHeader, ServiceRequest, Encounter) |
---|---|---|---|
Referral Request (New) | POST /$process-message{servicerequest-request} | ServiceRequest (active) | MessageHeader (EventCoding) = servicerequest-request |
MessageHeader (ReasonCode) = new | |||
ServiceRequest (Status) = active | |||
ServiceRequest (Category) = referral | |||
ServiceRequest (Category) = a1t1 | |||
Encounter (Status) = triaged/finished | |||
All resources to include 'lastUpdated' value, under meta section |
Additionally the HTTP request header would be:
NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_000001>
X-Correlation-Id = <GUID_000002>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR PractitionerRole (Base64 Encoded)}
NHSD-Requesting-Software = {FHIR Device (Base64 Encoded)}
The HTTP response header would be:
X-Request-Id = <GUID_000001>
X-Correlation-Id = <GUID_000002>
Cancel a Referral
To cancel a referral this Application follows the standard pattern for BaRS composite operations with an additional step. Before beginning the standard pattern as descbribed on the linked section, it is first necessary to retrieve the latest version of the referral from the receiver as it may have changed locally. This is done by performing a "GET ServiceRequest by ID" call to the receiving system's corresponding API endpoint (via the BaRS proxy).
The response to this request will be the requested ServiceRequest resource which should be checked for its current status to ensure it does not already have a status of "revoked". If not, this version of the ServiceRequest should be used when re-submitting the modified resource in the POST bundle as described in the standard pattern.
The message definition that defines this payload for this Application is: BARS Message Definition ServiceRequest - Request - Cancelled
As a general principle, when performing an update type of operation (of which cancellation is a special case), only the focus resource, any resources that are mandated due to contextual, linking or referential integrity reasons and any resources that include elements that are being changed. This is always defined within the relevent message definition.
In addition the specific workflow parameters that are required are as follows:
Interaction | Method | Payload Focus | Status Required (MessageHeader, ServiceRequest, Encounter) |
---|---|---|---|
Get Referral | GET /ServiceRequest/{id} | n/a | n/a |
Referral Request (Cancel) | POST /$process-message{servicerequest-request} | ServiceRequest (revoked) | MessageHeader (EventCoding) = servicerequest-request |
MessageHeader (ReasonCode) = update | |||
ServiceRequest (Status) = revoked | |||
ServiceRequest (Category) = referral | |||
ServiceRequest (Category) = a1t1 | |||
Encounter (Status) = triaged/finished | |||
All resources to include 'lastUpdated' value, under the meta section, which must be a later timestamp, on updates, if the content of a particular resource contains updated info. Otherwise, maintain the timestamp originally sent. |
Additionally the HTTP request header for the GET ServiceRequest would be:
NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_107>
X-Correlation-Id = <GUID_108>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR PractitionerRole (Base64 Encoded)}
NHSD-Requesting-Software = {FHIR Device (Base64 Encoded)}
The HTTP response header for the GET ServiceRequest would be:
X-Request-Id = <GUID_107>
X-Correlation-Id = <GUID_108>
the HTTP request header for the POST $process-message would be:
NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_000003>
X-Correlation-Id = <GUID_000002>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR PractitionerRole (Base64 Encoded)}
NHSD-Requesting-Software = {FHIR Device (Base64 Encoded)}
The HTTP response header for the POST $process-message would be:
X-Request-Id = <GUID_000003>
X-Correlation-Id = <GUID_000002>
Search for slots
During a referral workflow where booking is required, there are two separate processes that need to be undertaken sequentially. The first is to search for slots and once a slot has been selected, a booking can be made.
The first part of this process involves the sender making a request to the receiver for slots that match the search criteria. This is a "searching" request that requires the response body to include a "searchset" bundle resource.
The search parameters are defined on the BaRS API specification documentation.
Interaction | Method | Payload Focus | Status Required (MessageHeader, ServiceRequest, Encounter) |
---|---|---|---|
Get Slots | GET /GetSlots | n/a | n/a |
Additionally the HTTP request header for the GET Slots would be:
NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_00001>
X-Correlation-Id = <GUID_00002>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR PractitionerRole (Base64 Encoded)}
NHSD-Requesting-Software = {FHIR Device (Base64 Encoded)}
The HTTP response header for the GET Slots would be:
X-Request-Id = <GUID_00001>
X-Correlation-Id = <GUID_00002>
Make a booking
Making a booking for this Application follows the standard pattern for BaRS operations.
The message definition that defines this payload for this Application is: BARS Message Definition - Booking Request
In addition to that the specific workflow parameters that are required are as follows:
Interaction | Method | Payload Focus | Status Required (MessageHeader, ServiceRequest, Encounter) |
---|---|---|---|
Booking Request (New) | POST /$process-message{booking-request} | Appointment (booked) | MessageHeader (EventCoding) = booking-request |
MessageHeader (ReasonCode) = new | |||
Appointment (Status) = booked | |||
All resources to include 'lastUpdated' value, under meta section |
Additionally the HTTP request header would be:
NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_00003>
X-Correlation-Id = <GUID_00002>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR PractitionerRole (Base64 Encoded)}
NHSD-Requesting-Software = {FHIR Device (Base64 Encoded)}
The HTTP response header would be:
X-Request-Id = <GUID_00003>
X-Correlation-Id = <GUID_00002>
Cancel a Booking
To cancel a booking this Application follows the standard pattern for BaRS operations with an additional step. Before beginning the standard pattern as descbribed on the linked section, it is first necessary to retrieve the latest version of the booking from the receiver as it may have changed locally. This is done by performing a "GET Appointment by ID" call to the receiving system's corresponding API endpoint (via the BaRS proxy).
The response to this request will be the requested Appointment resource which should be checked for its current status to ensure it does not already have a status of "cancelled". If not, this version of the Appointment should be used when re-submitting the modified resource in the POST bundle as described in the standard pattern.
The message definition that defines this payload for this Application is: BARS Message Definition - Cancel Booking Request
As a general principle, when performing an update type of operation (of which cancellation is a special case), only the focus resource, any resources that are mandated due to contextual, linking or referential integrity reasons and any resources that include elements that are being changed. This is always defined within the relevent message definition.
In addition the specific workflow parameters that are required are as follows:
Interaction | Method | Payload Focus | Status Required (MessageHeader, ServiceRequest, Encounter) |
---|---|---|---|
Get Booking | GET /Appointment{id} | n/a | n/a |
Booking Request (Cancel) | POST /$process-message{booking-request} | Appointment (cancelled) | MessageHeader (EventCoding) = booking-request |
MessageHeader (ReasonCode) = update | |||
Appointment (Status) = cancelled | |||
All resources to include 'lastUpdated' value, under the meta section, which must be a later timestamp, on updates, if the content of a particular resource contains updated info. Otherwise, maintain the timestamp originally sent. |
Additionally the HTTP request header for the GET Appointment would be:
NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_00004>
X-Correlation-Id = <GUID_00002>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR PractitionerRole (Base64 Encoded)}
NHSD-Requesting-Software = {FHIR Device (Base64 Encoded)}
The HTTP response header for the GET Appointment would be:
X-Request-Id = <GUID_00004>
X-Correlation-Id = <GUID_00002>
the HTTP request header for the POST $process-message would be:
NHSD-Target-Identifier = {Receiver Service Identifier}
X-Request-Id = <GUID_00006>
X-Correlation-Id = <GUID_00002>
NHSD-End-User-Organisation = {FHIR Organisation (Base64 Encoded)}
NHSD-Requesting-Practitioner = {FHIR PractitionerRole (Base64 Encoded)}
NHSD-Requesting-Software = {FHIR Device (Base64 Encoded)}
The HTTP response header for the POST $process-message would be:
X-Request-Id = <GUID_00006>
X-Correlation-Id = <GUID_00002>
Bundle Processing - detailed
Below is a pseudo code example of how a bundle could be processed based on the above workflow variables:
> Logical - Based on a logical step through in a code format
Receive_Request { initialise_variable "messageType" initialise_variable "MessageReason" initialise_variable "RequestType" //HTTP_Headers { if (HttpHeaders is null || HttpHeaders not Guid ) OperationOutcome.issue.code = "invalid" throw exception with "REC_BAD_REQUEST" then return with HTTP.ResponseCode 400 else if (HttpHeaders.RequestId == RequestId.AlreadyReceived) OperationOutcome.issue.code = "duplicate" throw exception with "REC_CONFLICT" then return with HTTP.ResponseCode 409 } //Bundle { if(Bundle.meta.versionID is null) OperationOutcome.issue.code = "invariant" throw exception with "REC_BAD_REQUEST" then return with HTTP.ResponseCode 400 else if!(Bundle.meta.versionID in versionID.supported) OperationOutcome.issue.code = "not-supported" throw exception with "REC_UNPROCESSABLE_ENTITY" then return with HTTP.ResponseCode 422 } //Contents; { switch(MessageHeader.eventCoding) { case "servicerequest-request": if (MessageHeader.reason.code == "new" && ServiceRequest.status == "active") { switch(ServiceRequest.Category) { case "Referral": if (Careplan.status != "completed") { RequestType = "unknown" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400 } else if(Encounter.Status.In("triaged","finished")) RequestType = "Im Receiving a new Referral" else RequestType = "unknown" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400 break; default: RequestType = "unknown" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400; } } else if (MessageHeader.reason.code == "update") { switch(ServiceRequest.category) { case "Referral": if(ServiceRequest.status.In("entered-in-error","revoked")) {RequestType = "im receiving a cancelled referral"} else { RequestType = "unknown" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400 } break; default: RequestType = "unknown" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400; } } else { RequestType = "unknown" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400} break; case "servicerequest-response": if (MessageHeader.Response is null ) { RequestType = "Invalid servicerequest-response" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400; } else if ( !Message.Response.identifier.existsLocally()) { RequestType = "none or invalid response ID" OperationOutcome.issue.code = "not-found"//A content validation rule failed throw exception with "REC_NOT_FOUND" then return HTTP.ResponseCode 404; } switch (ServiceRequest.Category) { case "Referral": if (ServiceRequest.status == "revoked" && MessageHeader.reason.code == "new") { RequestType = "im receiving a Safeguarding DNA response (noshow)" } else { RequestType = "unknown" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400; } break; default: RequestType = "unknown" OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return HTTP.ResponseCode 400; } case "booking-request": if (MessageHeader.Reason.code== "new" && Appointment.Status == "booked") if(slot.IsFree()) {RequestType = "Im Receiving a new booking.";} else { OperationOutcome.issue.code = "conflict" throw exception with "REC_CONFLICT" then return with HTTP.ResponseCode 409 } else if (MessageHeader.Reason.code == "update") MessageHeaderIsUpdate = true; switch (Appointment.Status) { case "cancelled": RequestType = "Im Receiving a booking cancellation." break case "entered-in-error": RequestType = "Im Receiving a booking cancellation." break default: OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return with HTTP.ResponseCode 400; break; } else { OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with "REC_BAD_REQUEST" then return with HTTP.ResponseCode 400; } break; case "booking-response": OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with 'REC_BAD_REQUEST' then return with HTTP.ResponseCode 400 break; default: OperationOutcome.issue.code = "invariant"//A content validation rule failed throw exception with 'REC_BAD_REQUEST' then return with HTTP.ResponseCode 400 break; } } //Submit { if (Message == "update") { if (currentLocalData.LastUpdated > originaRequest.ReceivedDate) { OperationOutcome.issue.code = "conflict" throw exception with 'REC_CONFLICT' then return with HTTP.ResponseCode 409 break; } foreach (Entry in Bundle) { if (currentLocalData.Item.exists) { if (currentLocalData.LastUpdated > originaRequest.Received) { OperationOutcome.issue.code = "conflict" throw exception with 'REC_CONFLICT' then return with HTTP.ResponseCode 409 break; } if(Entry.LastUpdated > currentLocalData.Item.meta.LastUpdated && Entry.fullUrl = currentLocalData.Item.fullUrl) currentLocalData.Item = Entry.Item Entry.SubmitWith(currentLocalData.Item.meta.LastUpdated == Entry.LastUpdated ) else ignore } else Entry.SubmitWith(currentLocalData.Item.meta.LastUpdated == Entry.LastUpdated ) } Submit(currentLocalData.Bundle.meta.LastUpdated = Bundle.Meta.LastUpdated) return HTTP.ResponseCode 200 'OK' } else { foreach(Entry in Bundle) { Entry.SubmitWith(currentLocalData.Item.meta.LastUpdated == Entry.LastUpdated ) Submit(currentLocalData.Bundle.meta.LastUpdated = Bundle.Meta.LastUpdated) return HTTP.ResponseCode 200 'OK' } } } }
How bookings and referrals map to services in UEC workflows
Background
It is common for healthcare IT systems to present a single API endpoint that is shared between multiple healthcare services - this is particularly common where a system is centrally-hosted and multi-tenanted, or where an organisation has a single IT system that is used to provide multiple healthcare services.
For example, an NHS provider organisation, 'Trumpton Community Hospital', which provides several healthcare services available to urgent emergency care services, including an NHS 111 call centre, an Out of Hours (OOH) GP service, an Urgent Treatment Centre (UTC) and an Emergency Department. The OOH GP service may offer two sub-services on DoS: OOH GP Telephone Consultations, and OOH GP Face to face Consultations.
Each of the above would be represented in the DoS as discrete services.
Some service discovery tools (such as the UEC Directory of Services (DoS)) list services at the granular healthcare service level i.e. for each of the above example healthcare services, the DoS will have one or more service records defined. It is these individual service records that are presented to users when searching the DoS.
When a system making a booking (e.g. NHS 111) requests available slots from a healthcare service, it needs to identify exactly which healthcare service it is targeting. This will allow receiving systems to correctly route requests and filter the responses to be relevant to the specific request.
A Key concept here is that it is the receiver of appointments that controls what is returned. The system making the booking does NO filtering, just showing all the slots that are returned.
Use Healthcare Service ID to filter slot requests to specific healthcare services
A search parameter of the HealthcareService (an intrinsic part of FHIR RESTful search) will be sent.
As a sender, include the ID of the healthcare service as a parameter
As a sender, include a search parameter specifying the Service Discovery tool ID of the healthcare service to which the query is directed.
Example
If the DoS has returned a service "Village Urgent Treatment Centre (Dos Service ID:124459850)", in order to book an appointment at that service, ensuring only the available slots that are specific to that service are returned, include a Service ID parameter in the Slot request.
As a receiver, use the healthcare service ID to filter the slots returned in your response
As a system receiving bookings and referrals and providing slots, ensure that only the appropriate slots are returned slots in your response, honouring the request.
Filtering is based on the HealthcareService specified in the query (to filter slots provided by that specific service), along with a date/time range and the 'status' of the slot i.e. either 'free' or 'busy'.
Example
A Receiver runs three healthcare services from the same system:
- Walk-in Centre
- OOH GP Service
- Urgent Treatment Centre
Within the system these services are likely to have separate booking schedules.
The mapping between the healthcare service and booking schedules must align with the potential request for slots that could be received.
Service | DoS ID | Linked Schedule |
---|---|---|
Walk-in Centre | 124459850 | Schedule 1 |
Urgent Treatment Centre | 2329483525 | Schedule 2 |
OOH GP Service | 0123944122 | Schedule 3 |
Schedules can be shared between healthcare services, and such multiple mappings would look like this:
Service | DoS ID | Linked Schedule |
---|---|---|
Walk-in Centre | 124459850 | Schedule 1 |
Urgent Treatment Centre | 2329483525 | Schedule 1 |
Urgent Treatment Centre | 2329483525 | Schedule 2 |
OOH GP Service | 0123944122 | Schedule 2 |
OOH GP Service | 0123944122 | Schedule 3 |
As a receiving system, it is essentially up to healthcare service providers to decide how to filter the slots returned but it is important to consider that a sending system will assume that any returned slot is a valid slot for booking - it is important that the slots returned are genuinely available to the patient within the context of the request received.
Support for booking only services
Some services that are profiled on the Urgent Care Directory of Services are commissioned as "booking only" services. This means that these services will only accept a referral if a booking has also been made for that patient.
If no appointment is available then a referral should not be made.
To achieve this, a "service attribute" is configurable against services. This will allow the service to be flagged as "booking only". Therefore if this attribute is present on the service all consumer systems should withhold referrals. The DoS API documentation for this can be found here.
Workflow
An example workflow showing how this might be implemented is illustrated below:
Example xml returned:
When requesting DoS service details with "CheckCapacitySummary" DoS API call, there is a section in the returned message for the additional attributes:
<ns1:attributes> <attribute> <dataType>string</dataType> <name>requirebooking</name> <description>The service only accepts referrals with an accompanying booked appointment.</description> <value>true</value> </attribute> </ns1:attributes>
This attribute will have three possible states:
- not present
- present and false
- present and true
For the first two cases, it can be assumed that referrals can be made without a booking. Only if the attribute is present and true should a referral be withheld if there has been no booking.
Payloads
The specific guidance around the use of key FHIR resources is described below.
MessageHeader Resource
Standard Patterns for BaRS Operations explains in detail how the MessageHeader resource must be used.
The MessageHeader resource for the Booking Request should have the following resource elements set as follows:
- MessageHeader.eventCoding - must be populated with 'booking-request'
- MessageHeader.reasonCode - must be 'new' or 'update'
- MessageHeader.focus - must reference the Appointment FHIR resource
- MessageHeader.definition - must adhere to Booking Request Message definition
The MessageHeader resource for the Referral Request should have the following resource elements set as follows:
- MessageHeader.eventCoding - must be populated with 'servicerequest-request'
- MessageHeader.reasonCode - must be 'new' or 'update'
- MessageHeader.focus - must reference the ServiceRequest FHIR resource
- MessageHeader.definition - must adhere to Referral Request Message definition
ServiceRequest Resource
The primary resource in a referral is the ServiceRequest resource. When the request 'message bundle' is created by the Sender and processed by the Receiver, this is the starting point from which the referral is understood. It provides either the detail or references to all key FHIR resources, for example, the Patient, Encounter and Careplan. The guidance for this resource below provides more granular, element level, detail. A key point when a Sender builds the referral FHIR 'message bundle' is to ensure the MessageHeader.focus references the ServiceRequest resource.
There are two coding entries within ServiceRequest.category which are key to driving workflow:
- Denotes the type of referral e.g. Transfer of care
- Denotes the use case and must be populated with the relevant use case from use-case CodeSystem. e.g. 111 - ED. 999 - UTC, CAS - SEDEC. Please refer to the guidance in use-case categories
An important function of the ServiceRequest resource is to link the booking and referral when they are related in a workflow. If the booking is successfully made before the referral, the Sender will have the Appointment.Id value (from the synchronous HTTP response) and this must be included as a relative reference, under ServiceRequest.supportingInfo, in the referral request. The element ServiceRequest.supportingInfo may also be used to provide reference to other resources in the request i.e. Rejected Services. This is outlined in the element guidance below.
Appointment
The primary resource in a booking is the Appointment resource. When the request 'message bundle' is created by the Sender and processed by the Receiver, this is the starting point from which the booking is understood. It provide either the detail or references to all key FHIR resources. When a Sender builds the booking FHIR 'message bundle' they must ensure the MessageHeader.focus references the Appointment resource.
An important function of the Appointment resource is to link the booking and referral when they are related in a workflow. If the referral is successfully made before the booking, the Sender will have the ServiceRequest.Id value (from the synchronous HTTP response) and this must be included as a relative reference, under Appointment.basedOn, in the booking request.
Encounter Resource
The Encounter is used to represent the interaction between a patient and healthcare service provider. It links with numerous other resources, to reflect the assessment performed.
In the initial referral request, the Sender will include an Encounter resource as the container for their assessment, which established the need for the referral. This encounter should include a reference to the Sender's assessment under encounter.identifier. Additionally, the encounter.episodeOfCare must be populated with a 'Journey ID' reference which can be used in subsequent referrals to allow the audit of the route a patient took through service providers to resolve their initial request for care.
A second Encounter resource is used to transfer the human readable reference of the newly created referral, at the Receiver side. When a referral request is made, the Receiver should include a new, secondary, encounter resource with the status of 'planned' in their synchronous HTTP response to the Sender's request. This new 'planned' encounter will have both an Id and an Identifier value, indicating the Receiver's human readable and local references, respectively. This secondary, 'planned', encounter is not mandatory and has a cardinality of 0..1, unlike the primary encounter resource (1..1)(See the Entity Relationship Diagram for reference). The human readable (Identifier) reference is intended to allow Senders to provide something to the patient which they can take between services to support consistent joined up care, although, it is also a useful link for the services themselves to use when discussing a patient's transition of care. The local (Id) reference is not intended to be human readable but rather machine readable.
CarePlan Resource
The CarePlan resource is used in a referral request to communicate the assessment triage outcome and any associated clinical information, based on the assessment performed by the Sender. The Receiver will utilise the detail in this resource to summarise what the previous assessment ascertained about the patient, to be used in any subsequent consultation with the patient.
Primarily, careplan.activity is the section which holds this information, whether it be coded or free text. The careplan.activity.outcomeCodeableConcept is malleable enough to support the transmission of Pathways coded outcomes as well as clinical narrative. The element guidance for this resource below goes into the specific detail but, fundamentally, the Sender must include the selected Pathway, Symptom Group, Symptom Discriminator and Disposition (DX) code, along with the Pathways Assessment report. Further clinical narrative, provided outside of the Pathways assessment, can also be included under this element using 'text'.
Flag Resource
The Flag resource is used to communicate prospective warnings of potential issues when providing care to the patient. The population of the Flag Resource is optional as not all subjects will have relevant issues.
BaRS Senders should populate Flag resources and should make adequate provision in their solution to support key flags in BaRS Application workflows, for example, Safeguarding, for this Application. When populating this resource, Senders must include both flag.category and flag.code values using the specific BaRS CodeSystems.
When a BARS Receiver processes information in a Flag resource;
- they should populate a flag in their system, if their solution supports that flag
- they must display the information in the Flag resource in a way that supports the associated workflow (i.e. the relevant end users can see it and act upon it)
- rendering of Flag information must be in line with the Principles for rendering BaRS Payload.
Observation
The Observation resource is used to carry assertions supporting the assessment performed by the Sender. In the BaRS UEC Applications, Senders should add clinical notes to the Careplan resource rather than Observation, especially where they expect a Receiver to act upon the information.
There are specific instances where an Observation must be used to convey information and examples are provided to aid development:
- Birth Sex must be transferred in a referral using Observation. This information should only be transferred when considered clinically relevant and it is not considered as demographic information, as administrative gender would be. It should not be included as an extension on the patient resource, as described in UK Core.
- Estimated Age must be conveyed in an Observation.
QuestionnaireResponse
QuestionnaireResponse is optionally used to carry structured data in BaRS UEC Applications, specifically, to communicate:
- references to external sources of clinical information, looked up during the Sender's assessment
- Special Patient Notes (SPNs) held locally by the Sender and linked to the patient. Typically, this information is not available to retrieve from other sources and, therefore, must be included in its entirety.
- any Rejected Services by the patient prior to selection on the Receiver service
The extension questionnaireresponse-reason must be populated to indicate which data is contained within, as outlined in the resource element guidance below.
Using a nested set of questionnaireResponse.item, questionnaireResponse.linkId and questionnaireResponse.answer complex structured data can be generated and processed, by the Sender and Receiver, respectively. The element guidance for this resource below goes into detail but, essentially, the item and linkId can be continually nested to convey various types of information. The item indicates a new element, linkId provide the number of elements (within the item) and answer contains any the value, supported by many different data types.
Consent
In the BaRS UEC Applications the level of consent is stipulated to be for 'Direct Care' only. A referral must contain a Consent resource and it must adhere to the example provided under the BaRS FHIR assets.
Payload for requesting a referral, using Service Request
This payload is used to transmit all the necessary information that is required for an urgent or emergency care service to accept a patient referred into their service.
> Bundle
The Bundle resource is the container for the event message
BARSBundleMessage (Bundle) | I | There are no (further) constraints on this element Element idBundle Contains a collection of resources DefinitionA container for a collection of resources.
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id | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idBundle.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idBundle.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idBundle.identifier Persistent identifier for the bundle DefinitionA persistent identifier for the bundle that won't change as a bundle is copied from server to server. Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idBundle.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idBundle.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference() | There are no (further) constraints on this element Element idBundle.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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type | Σ | 1..1 | codeBindingFixed Value | Element idBundle.type document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection DefinitionIndicates the purpose of this bundle - how it is intended to be used. It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types. Indicates the purpose of a bundle - how it is intended to be used.
message
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timestamp | Σ | 1..1 | instant | There are no (further) constraints on this element Element idBundle.timestamp When the bundle was assembled DefinitionThe date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated. Usage:
The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.
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total | Σ I | 0..1 | unsignedInt | There are no (further) constraints on this element Element idBundle.total If search, the total number of matches DefinitionIf a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle. Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources.
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link | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idBundle.link Links related to this Bundle DefinitionA series of links that provide context to this bundle. Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.link.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.link.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.link.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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relation | Σ | 1..1 | string | There are no (further) constraints on this element Element idBundle.link.relation See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1 DefinitionA name which details the functional use for this link - see http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1.
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url | Σ | 1..1 | uri | There are no (further) constraints on this element Element idBundle.link.url Reference details for the link DefinitionThe reference details for the link.
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entry | Σ I | 0..* | BackboneElement | There are no (further) constraints on this element Element idBundle.entry Entry in the bundle - will have a resource or information DefinitionAn entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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link | Σ | 0..* | see (link) | There are no (further) constraints on this element Element idBundle.entry.link Links related to this entry DefinitionA series of links that provide context to this entry.
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fullUrl | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.entry.fullUrl URI for resource (Absolute URL server address or URI for UUID/OID) DefinitionThe Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that:
fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
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resource | Σ | 0..1 | Resource | There are no (further) constraints on this element Element idBundle.entry.resource A resource in the bundle DefinitionThe Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. |
search | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.search Search related information DefinitionInformation about the search process that lead to the creation of this entry.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.search.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.search.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.search.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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mode | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.entry.search.mode match | include | outcome - why this is in the result set DefinitionWhy this entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process. There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, 'match' takes precedence. Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
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score | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idBundle.entry.search.score Search ranking (between 0 and 1) DefinitionWhen searching, the server's search ranking score for the entry. Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order. See Patient Match for the EMPI search which relates to this element.
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request | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.request Additional execution information (transaction/batch/history) DefinitionAdditional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.request.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.request.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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method | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idBundle.entry.request.method GET | HEAD | POST | PUT | DELETE | PATCH DefinitionIn a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred. HTTP verbs (in the HTTP command line). See HTTP rfc for details.
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url | Σ | 1..1 | uri | There are no (further) constraints on this element Element idBundle.entry.request.url URL for HTTP equivalent of this entry DefinitionThe URL for this entry, relative to the root (the address to which the request is posted). E.g. for a Patient Create, the method would be "POST" and the URL would be "Patient". For a Patient Update, the method would be PUT and the URL would be "Patient/[id]".
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ifNoneMatch | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifNoneMatch For managing cache currency DefinitionIf the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
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ifModifiedSince | Σ | 0..1 | instant | There are no (further) constraints on this element Element idBundle.entry.request.ifModifiedSince For managing cache currency DefinitionOnly perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
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ifMatch | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifMatch For managing update contention DefinitionOnly perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
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ifNoneExist | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifNoneExist For conditional creates DefinitionInstruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for "Conditional Create". This is just the query portion of the URL - what follows the "?" (not including the "?").
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response | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.response Results of execution (transaction/batch/history) DefinitionIndicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.response.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.response.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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status | Σ | 1..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.status Status response code (text optional) DefinitionThe status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code.
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location | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.entry.response.location The location (if the operation returns a location) DefinitionThe location header created by processing this operation, populated if the operation returns a location.
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etag | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.etag The Etag for the resource (if relevant) DefinitionThe Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
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lastModified | Σ | 0..1 | instant | There are no (further) constraints on this element Element idBundle.entry.response.lastModified Server's date time modified DefinitionThe date/time that the resource was modified on the server. This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
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outcome | Σ | 0..1 | Resource | There are no (further) constraints on this element Element idBundle.entry.response.outcome OperationOutcome with hints and warnings (for batch/transaction) DefinitionAn OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned. This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error. |
signature | Σ | 0..1 | Signature | There are no (further) constraints on this element Element idBundle.signature Digital Signature DefinitionDigital Signature - base64 encoded. XML-DSig or a JWT. A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient. The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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type | Σ | 1..* | CodingBinding | There are no (further) constraints on this element Element idBundle.signature.type Indication of the reason the entity signed the object(s) DefinitionAn indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document. Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication". An indication of the reason that an entity signed the object.
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when | Σ | 1..1 | instant | There are no (further) constraints on this element Element idBundle.signature.when When the signature was created DefinitionWhen the digital signature was signed. This should agree with the information in the signature.
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who | Σ | 1..1 | Reference(Device | | | | | ) | There are no (further) constraints on this element Element idBundle.signature.who Who signed DefinitionA reference to an application-usable description of the identity that signed (e.g. the signature used their private key). This should agree with the information in the signature.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.who.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idBundle.signature.who.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idBundle.signature.who.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.who.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.signature.who.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idBundle.signature.who.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.signature.who.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idBundle.signature.who.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference() | There are no (further) constraints on this element Element idBundle.signature.who.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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onBehalfOf | Σ | 0..1 | Reference(Device | | | | | ) | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf The party represented DefinitionA reference to an application-usable description of the identity that is represented by the signature. used when the signature is on behalf of a non-signer. The party that can't sign. For example a child.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference() | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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targetFormat | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.signature.targetFormat The technical format of the signed resources DefinitionA mime type that indicates the technical format of the target resources signed by the signature. "xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here. The mime type of an attachment. Any valid mime type is allowed.
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sigFormat | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.signature.sigFormat The technical format of the signature DefinitionA mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc. The mime type of an attachment. Any valid mime type is allowed.
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data | 0..1 | base64Binary | There are no (further) constraints on this element Element idBundle.signature.data The actual signature content (XML DigSig. JWS, picture, etc.) DefinitionThe base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty. Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.
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Data Item | Implementation Guidance | Necessity | Profile Cardinality | Example Value(s) |
---|---|---|---|---|
Bundle | https://simplifier.net/nhsbookingandreferrals/barsbundlemessage | 1..1 | ||
Bundle.id | This id is generated by the originating sender of the message, retained in subsequent messages.. | MUST | 1..1 | 79120f41-a431-4f08-bcc5-1e67006fcae0 |
Bundle.meta | https://www.hl7.org/fhir/resource.html#Meta | MUST | 0..1 | |
Bundle.meta.profile | This MUST be populated with the structure definition for BaRSBundleMessage : 'https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage' - FIXED VALUE | MUST | 0..1 | https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage |
Bundle.meta.lastUpdated | All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. | MUST | 0..1 | 2023-03-08T12:01:08.4677672+00:00 |
Bundle.type | This MUST be populated with 'message' - FIXED VALUE | MUST | 1..1 | message |
Bundle.timestamp | This MUST be populated with the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message | MUST | 1..1 | 2023-03-08T12:01:08.4677672+00:00 |
Bundle.entry(s) | Follow BaRS profile guidance for populating this element | MUST | 0..* | |
Bundle.entry.fullUrl | This MUST be populated with the unique identifier for the resource entry. Transient id relative to the bundle | MUST | 0..1 | urn:uuid:1cbdfb97-5859-48a4-8301-d54eab818d68 |
Bundle.entry.resourceType | This MUST be populated with the Resources detailed in the message definition. | MUST | 0..1 | MessageHeader,Patient, Encounter |
A resource that describes the BaRS message being exchanged between two systems. It defines the way that the referral bundle should be processed when it is being consumed by a receiver A resource that describes a message that is exchanged between systems The header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) An extension to carry a specific instruction for receivers of the message. extensions, user content An extension to carry a specific instruction for receivers of the message. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MessageHeaderInstruction Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Code for the event this message represents or link to event definition Code that identifies the event this message represents and connects it with its definition. Events defined as part of the FHIR specification have the system value "http://terminology.hl7.org/CodeSystem/message-events". Alternatively uri to the EventDefinition. Drives the behavior associated with this message. The time of the event will be found in the focus resource. The time of the message will be found in Bundle.timestamp. Message event Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Message destination application(s) The destination application which the message is intended for. Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient". There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Name of system Human-readable name for the target system. May be used for routing of response and/or to support audit. Particular delivery destination within the destination Identifies the target end system in situations where the initial message transmission is to an intermediary system. Supports multi-hop routing. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Actual destination address or id Indicates where the message should be routed to. Identifies where to route the message. The id may be a non-resolvable URI for systems that do not use standard network-based addresses. Intended "real-world" recipient for the data Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient. Allows routing beyond just the application level. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Real world sender of the message Identifies the sending system to allow the use of a trust relationship. Allows routing beyond just the application level. Use case is for where a (trusted) sending system is responsible for multiple organizations, and therefore cannot differentiate based on source endpoint / authentication alone. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The source of the data entry The person or device that performed the data entry leading to this message. When there is more than one candidate, pick the most proximal to the message. Can provide other enterers in extensions. Need to know for audit/traceback requirements and possibly for authorization. Usually only for the request but can be used in a response. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The source of the decision The logical author of the message - the person or device that decided the described event should happen. When there is more than one candidate, pick the most proximal to the MessageHeader. Can provide other authors in extensions. Need to know for audit/traceback requirements and possibly for authorization. Usually only for the request but can be used in a response. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Message source application The source application from which this message originated. Allows replies, supports audit. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Optional Extensions Element extensions, user content Optional Extension Element - found in all resources. 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. Extension(Complex) https://fhir.nhs.uk/StructureDefinition/CDSSExtension Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Name of system Human-readable name for the source system. May be used to support audit. Name of software running the system May include configuration or other information useful in debugging. Supports audit and possibly interface engine behavior. Version of software running Can convey versions of multiple systems in situations where a message passes through multiple hands. Supports audit and possibly interface engine behavior. Human contact for problems An e-mail, phone, website or other contact point to use to resolve issues with message communications. Allows escalation of technical issues. Actual message source address or id Identifies the routing target to send acknowledgements to. Identifies where to send responses, may influence security permissions. The uri of the Requester’s endpoint Final responsibility for event The person or organization that accepts overall responsibility for the contents of the message. The implication is that the message event happened under the policies of the responsible party. Need to know for audit/traceback requirements and possibly for authorization. Usually only for the request but can be used in a response. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Cause of event Coded indication of the cause for the event - indicates a reason for the occurrence of the event that is a focus of this message. Need to be able to track why resources are being changed and report in the audit log/history of the resource. May affect authorization. Reason for event occurrence. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Identity of the terminology system The identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Version of the system - if relevant The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Symbol in syntax defined by the system A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Representation defined by the system A representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. If this coding was chosen directly by the user Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Plain text representation of the concept A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings. If this is a reply to prior message Information about the message that this message is a response to. Only present if this message is a response. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Id of original message The MessageHeader.id of the message to which this message is a response. Allows receiver to know what message is being responded to. ok | transient-error | fatal-error Code that identifies the type of response to the message - whether it was successful or not, and whether it should be resent or not. Allows the sender of the acknowledge message to know if the request was successful or if action is needed. This is a generic response to the request message. Specific data for the response will be found in MessageHeader.focus. The kind of response to a message. Specific list of hints/warnings/errors Full details of any issues found in the message. Allows the sender of the message to determine what the specific issues are. This SHALL be contained in the bundle. If any of the issues are errors, the response code SHALL be an error. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The actual content of the message The actual data of the message - a reference to the root/focus class of the event. Every message event is about actual data, a single resource, that is identified in the definition of the event, and perhaps some or all linked resources. The data is defined where the transaction type is defined. The transaction data is always included in the bundle that is the full message. Only the root resource is specified. The resources it references should be contained in the bundle but are not also listed here. Multiple repetitions are allowed to cater for merges and other situations with multiple focal targets. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Link to the definition for this message Permanent link to the MessageDefinition for this message. Allows sender to define the expected contents of the message.
> Message Header
BARSMessageHeaderServiceRequestRequest (MessageHeader) I MessageHeader
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string MessageHeader.id
meta Σ 0..1 Meta MessageHeader.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri MessageHeader.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding MessageHeader.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative MessageHeader.text
hasValue() or (children().count() > id.count())
contained 0..* Resource MessageHeader.contained
extension I 0..* Extension MessageHeader.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
messageHeaderInstruction I 0..* Extension(Coding) MessageHeader.extension:messageHeaderInstruction
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension MessageHeader.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
event[x] Σ 1..1 Binding MessageHeader.event[x]
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.event[x].id
extension I 0..* Extension MessageHeader.event[x].extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system 1.. MessageHeader.event[x].system
code 1.. MessageHeader.event[x].code
eventCoding Coding eventUri uri destination Σ 1..* BackboneElement MessageHeader.destination
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.id
extension I 0..* Extension MessageHeader.destination.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension MessageHeader.destination.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
name Σ 0..1 string MessageHeader.destination.name
hasValue() or (children().count() > id.count())
target Σ 0..1 Reference() MessageHeader.destination.target
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.target.id
extension I 0..* Extension MessageHeader.destination.target.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.destination.target.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.destination.target.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.destination.target.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.target.identifier.id
extension I 0..* Extension MessageHeader.destination.target.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.destination.target.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.destination.target.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.destination.target.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.destination.target.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.destination.target.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.destination.target.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.destination.target.display
hasValue() or (children().count() > id.count())
endpoint Σ 1..1 url MessageHeader.destination.endpoint
hasValue() or (children().count() > id.count())
receiver Σ 0..1 Reference( | | ) MessageHeader.destination.receiver
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.receiver.id
extension I 0..* Extension MessageHeader.destination.receiver.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 1..1 string MessageHeader.destination.receiver.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.destination.receiver.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.destination.receiver.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.receiver.identifier.id
extension I 0..* Extension MessageHeader.destination.receiver.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.destination.receiver.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.destination.receiver.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.destination.receiver.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.destination.receiver.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.destination.receiver.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.destination.receiver.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.destination.receiver.display
hasValue() or (children().count() > id.count())
sender Σ 0..1 Reference( | | ) MessageHeader.sender
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.sender.id
extension I 0..* Extension MessageHeader.sender.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 1..1 string MessageHeader.sender.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.sender.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.sender.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.sender.identifier.id
extension I 0..* Extension MessageHeader.sender.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.sender.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.sender.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.sender.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.sender.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.sender.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.sender.identifier.assigner
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.sender.identifier.assigner.id
extension I 0..* Extension MessageHeader.sender.identifier.assigner.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 1..1 string MessageHeader.sender.identifier.assigner.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.sender.identifier.assigner.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.sender.identifier.assigner.identifier
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.sender.identifier.assigner.display
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.sender.display
hasValue() or (children().count() > id.count())
enterer Σ 0..1 Reference( | ) MessageHeader.enterer
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.enterer.id
extension I 0..* Extension MessageHeader.enterer.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.enterer.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.enterer.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.enterer.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.enterer.identifier.id
extension I 0..* Extension MessageHeader.enterer.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.enterer.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.enterer.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.enterer.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.enterer.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.enterer.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.enterer.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.enterer.display
hasValue() or (children().count() > id.count())
author Σ 0..1 Reference( | ) MessageHeader.author
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.author.id
extension I 0..* Extension MessageHeader.author.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.author.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.author.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.author.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.author.identifier.id
extension I 0..* Extension MessageHeader.author.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.author.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.author.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.author.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.author.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.author.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.author.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.author.display
hasValue() or (children().count() > id.count())
source Σ 1..1 BackboneElement MessageHeader.source
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.source.id
extension I 0..* Extension Element id MessageHeader.source.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
myExtension I 0..* Extension(Complex) Element id MessageHeader.source.extension:myExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension MessageHeader.source.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
name Σ 0..1 string MessageHeader.source.name
hasValue() or (children().count() > id.count())
software Σ 0..1 string MessageHeader.source.software
hasValue() or (children().count() > id.count())
version Σ 0..1 string MessageHeader.source.version
hasValue() or (children().count() > id.count())
contact Σ 0..1 ContactPoint MessageHeader.source.contact
hasValue() or (children().count() > id.count())
endpoint Σ 1..1 url Element id MessageHeader.source.endpoint
hasValue() or (children().count() > id.count())
responsible Σ 0..1 Reference( | | ) MessageHeader.responsible
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.responsible.id
extension I 0..* Extension MessageHeader.responsible.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.responsible.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.responsible.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.responsible.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.responsible.identifier.id
extension I 0..* Extension MessageHeader.responsible.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.responsible.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.responsible.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.responsible.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.responsible.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.responsible.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.responsible.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.responsible.display
hasValue() or (children().count() > id.count())
reason Σ 1..1 CodeableConcept MessageHeader.reason
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.reason.id
extension I 0..* Extension MessageHeader.reason.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
coding Σ 0..* Coding MessageHeader.reason.coding
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.reason.coding.id
extension I 0..* Extension MessageHeader.reason.coding.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ 0..1 uriFixed Value Element id MessageHeader.reason.coding.system
hasValue() or (children().count() > id.count())
https://fhir.nhs.uk/CodeSystem/message-reason-bars
version Σ 0..1 string MessageHeader.reason.coding.version
hasValue() or (children().count() > id.count())
code Σ 0..1 code MessageHeader.reason.coding.code
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.reason.coding.display
hasValue() or (children().count() > id.count())
userSelected Σ 0..1 boolean MessageHeader.reason.coding.userSelected
hasValue() or (children().count() > id.count())
text Σ 0..1 string MessageHeader.reason.text
hasValue() or (children().count() > id.count())
response Σ 0..1 BackboneElement MessageHeader.response
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.response.id
extension I 0..* Extension MessageHeader.response.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension MessageHeader.response.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 1..1 id MessageHeader.response.identifier
hasValue() or (children().count() > id.count())
code Σ 1..1 codeBinding MessageHeader.response.code
hasValue() or (children().count() > id.count())
details Σ 0..1 Reference() MessageHeader.response.details
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.response.details.id
extension I 0..* Extension MessageHeader.response.details.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.response.details.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.response.details.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.response.details.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.response.details.identifier.id
extension I 0..* Extension MessageHeader.response.details.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.response.details.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.response.details.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.response.details.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.response.details.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.response.details.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.response.details.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.response.details.display
hasValue() or (children().count() > id.count())
focus Σ 0..* Reference(Resource) MessageHeader.focus
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.focus.id
extension I 0..* Extension MessageHeader.focus.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 1..1 string MessageHeader.focus.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.focus.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.focus.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.focus.identifier.id
extension I 0..* Extension MessageHeader.focus.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.focus.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.focus.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.focus.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.focus.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.focus.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.focus.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.focus.display
hasValue() or (children().count() > id.count())
definition Σ 0..1 canonical(MessageDefinition) MessageHeader.definition
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
MessageHeader
https://simplifier.net/nhsbookingandreferrals/barsmessageheaderservicerequestrequest
1..1
MessageHeader.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
0..1
MessageHeader.meta.profile
This MUST be populated with the structure definition for BaRSMessageHeader-servicerequest-request.
MUST
0..1
https://fhir.nhs.uk/StructureDefinition/BARSMessageHeader-servicerequest-request
MessageHeader.meta.lastUpdated
All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
0..1
2023-03-08T12:01:08.4677672+00:00
MessageHeader.extension
This MUST be populated with details of the Clinical Decision Support System used
MUST
0..*
MessageHeader.extension.url
This MUST be populated with 'https://fhir.nhs.uk/StructureDefinition/CDSSExtension' - FIXED VALUE
MUST
1..1
https://fhir.nhs.uk/StructureDefinition/CDSSExtension
MessageHeader.extension.extension
MUST
0..*
MessageHeader.extension.extension.url
This MUST be populated with the pre-defined Clinical Decision Support System software url - FIXED VALUE
MUST
1..1
requesterCDSSSoftware
MessageHeader.extension.extension.valueString
This MUST be populated with the Clinical Decision Support System software name e.g. Pathways
MUST
0..1
Pathways
MessageHeader.extension.extension
MUST
0..*
MessageHeader.extension.extension.url
This MUST be populated with the pre-defined Clinical Decision Support System software Version url - FIXED VALUE
MUST
1..1
requesterCDSSVersion
MessageHeader.extension.extension.valueString
This MUST be populated with the Clinical Decision Support System software Version name e.g. 30.2.0
MUST
0..1
30.2.0
MessageHeader.eventcoding
MUST
1..1
MessageHeader.eventcoding.system
This MUST be populated with CodeSystem 'https://fhir.nhs.uk/CodeSystem/message-events-bars' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/message-events-bars
MessageHeader.eventcoding.code
The status MUST be populated with 'servicerequest-request'. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-events-bars' - FIXED VALUE
MUST
0..1
servicerequest-request
MessageHeader.destination
MUST
0..1
MessageHeader.destination.receiver
MUST
0..1
MessageHeader.destination.receiver.reference
This MUST be populated with the full url to the Receiving Organisation resource.
MUST
0..1
urn:uuid:10397afd-479c-42ea-9d5d-e4024481e0f8
MessageHeader.destination.endpoint
This MUST be populated with the system and Service ID separated by a pipe. for example https://fhir.nhs.uk/id/dos-service-id\|11111111, this is to ensure the receiver knows the intended destination.
MUST
1..1
https://fhir.nhs.uk/id/dos-service-id\|1122334455
MessageHeader.sender
MUST
0..1
MessageHeader.sender.reference
This MUST be populated. Follow BaRS profile guidance for populating this element
MUST
0..1
urn:uuid:07939a0c-2854-46ff-9282-ad906bc93679
MessageHeader.source
MUST
1..1
MessageHeader.source.name
This MUST be populated with the sending system supplier name
MUST
0..1
Patient Access System
MessageHeader.source.software
This SHOULD be populated with the sending software application name
SHOULD
0..1
Supplier Software
MessageHeader.source.version
This SHOULD be populated with the sending software version
SHOULD
0..1
V1.0.0
MessageHeader.source.contact
SHOULD
0..1
MessageHeader.source.contact.system
This SHOULD be populated with the Contact Type - phone | fax | email | pager | url | sms | other
SHOULD
0..1
phone
MessageHeader.source.contact.value
This SHOULD be populated with the Contact Type value
SHOULD
0..1
+44 (0123) 123 4567
MessageHeader.source.endpoint
This MUST be populated with the system and Service ID separated by a pipe. for example https://fhir.nhs.uk/id/dos-service-id\|11111111, this is to ensure the receiver knows where any response messages SHOULD be addressed.
MUST
1..1
https://fhir.nhs.uk/id/dos-service-id\\|5566778899
MessageHeader.reason
MUST
0..1
MessageHeader.reason.coding
MUST
0..1
MessageHeader.reason.coding.system
This MUST be populated with 'https://fhir.nhs.uk/CodeSystem/message-reason-bars' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/message-reason-bars
MessageHeader.reason.coding.code
This MUST be populated with 'new' in a new message and 'update' for an update. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-events-bars'
MUST
0..1
new
MessageHeader.reason.coding.display
This SHOULD be populated with 'new' in a new message and 'update' for an update.
SHOULD
0..1
New
MessageHeader.focus
MUST
0..*
MessageHeader.focus.reference
This MUST be populated with a reference to the ServiceRequest
MUST
0..1
urn:uuid:236bb75d-90ef-461f-b71e-fde7f899802c
MessageHeader.definition
This MUST be populated with the MessageDefinition the bundle is based on. This will be used for validation. Value - https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-request-referral
MUST
0..1
https://fhir.nhs.uk/MessageDefinition/bars-message-servicerequest-request-referral
This Resource is the focus of the Referral interaction A request for a service to be performed diagnostic request, referral, referral request, transfer of care request A record of a request for service such as diagnostic investigations, treatments, or operations to be performed. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) This represents the source of referral extensions, user content This represents the source of referral. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-SourceOfServiceRequest Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Identifiers assigned to this order Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller. The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Instantiates FHIR protocol or definition The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. canonical(ActivityDefinition | PlanDefinition) Instantiates external protocol or definition The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. What request fulfills fulfills Plan/proposal/order fulfilled by this request. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. What request replaces supersedes, prior, renewed order The request takes the place of the referenced completed or terminated request(s). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Composite Request ID grouperId, groupIdentifier A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier. Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes. Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. draft | active | on-hold | revoked | completed | entered-in-error | unknown The status of the order. The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource. The status of a service order. proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Whether the request is a proposal, plan, an original order or a reflex order. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. The kind of service request. Classification of service A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure"). Used for filtering what service request are retrieved and displayed. There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set. Classification of the requested service. routine | urgent | asap | stat Indicates how quickly the ServiceRequest should be addressed with respect to other requests. If missing, this task should be performed with normal priority Identifies the level of importance to be assigned to actioning the request. True if service/procedure should not be performed Set this to true if the record is saying that the service/procedure should NOT be performed. Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc. In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation. If missing, the request is a positive request e.g. "do perform" What is being requested/ordered service requested A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested. Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code. A set of codes that define a procedure or a procedure with explicit context. Selected from the SNOMED CT UK coding system. Additional order information detailed instructions Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied. For information from the medical record intended to support the delivery of the requested services, use the Codified order entry details which are based on order context. Service amount An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction). When ordering a service the number of service items may need to be specified separately from the the service item. Individual or Entity the service is ordered for On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Encounter in which the request was created context An encounter that provides additional information about the healthcare context in which this request is made. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. When service should occur schedule The date/time at which the requested service should occur. Preconditions for service If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc. A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc. Date request signed orderedOn When the request transitioned to being actionable. DateTime the Referral Request was generated Who/what is requesting service author, orderer The individual who initiated the request and has responsibility for its activation. This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource. Reference( | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Performer role specialty Desired type of performer for doing the requested service. This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”. Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc. Requested performer request recipient The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc. Referral To Reference( | | | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Requested location The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center. A location type where services are delivered. Requested location A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Explanation/Justification for procedure or service An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use A set of codes that define a reason for a service request. Explanation/Justification for service or service Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in Reference( | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Associated insurance coverage Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service. Reference(Coverage | ClaimResponse) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Additional clinical information Ask at order entry question, AOE Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements. To represent information about how the services are to be delivered use the Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Procedure Samples One or more specimens that the laboratory procedure will use. Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Location on Body location Anatomic location where the procedure should be performed. This is the target site. Knowing where the procedure is performed is important for tracking if multiple sites are possible. Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure. A set of codes that define an anatomical or acquired body structure site. Selected from the SNOMED CT UK coding system. Comments Any other notes and comments made about the service request. For example, internal billing notes. Patient or consumer-oriented instructions Instructions in terms that are understood by the patient or consumer. Request provenance Key events in the history of the request. This might not include provenances for all versions of the request – only those deemed “relevant” or important.
This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude
All Provenances should have some historical version of this Request as their subject. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
> Service Request
BARSServiceRequestRequestReferral (ServiceRequest) I ServiceRequest
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
orderDetail.empty() or code.exists()
id Σ 0..1 string ServiceRequest.id
meta Σ 0..1 Meta ServiceRequest.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri ServiceRequest.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding ServiceRequest.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative ServiceRequest.text
hasValue() or (children().count() > id.count())
contained 0..* Resource ServiceRequest.contained
extension I 0..* Extension ServiceRequest.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
sourceOfServiceRequest I 0..1 Extension(CodeableConcept) ServiceRequest.extension:sourceOfServiceRequest
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension ServiceRequest.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier ServiceRequest.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.identifier.id
extension I 0..* Extension ServiceRequest.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.identifier.assigner
hasValue() or (children().count() > id.count())
instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) ServiceRequest.instantiatesCanonical
hasValue() or (children().count() > id.count())
instantiatesUri Σ 0..* uri ServiceRequest.instantiatesUri
hasValue() or (children().count() > id.count())
basedOn Σ 0..* Reference( | | ) ServiceRequest.basedOn
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.basedOn.id
extension I 0..* Extension ServiceRequest.basedOn.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.basedOn.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.basedOn.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.basedOn.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.basedOn.identifier.id
extension I 0..* Extension ServiceRequest.basedOn.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.basedOn.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.basedOn.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.basedOn.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.basedOn.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.basedOn.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.basedOn.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.basedOn.display
hasValue() or (children().count() > id.count())
replaces Σ 0..* Reference() ServiceRequest.replaces
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.replaces.id
extension I 0..* Extension ServiceRequest.replaces.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.replaces.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.replaces.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.replaces.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.replaces.identifier.id
extension I 0..* Extension ServiceRequest.replaces.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.replaces.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.replaces.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.replaces.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.replaces.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.replaces.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.replaces.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.replaces.display
hasValue() or (children().count() > id.count())
requisition Σ 0..1 Identifier ServiceRequest.requisition
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.requisition.id
extension I 0..* Extension ServiceRequest.requisition.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.requisition.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.requisition.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.requisition.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.requisition.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.requisition.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.requisition.assigner
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding ServiceRequest.status
hasValue() or (children().count() > id.count())
intent Σ ?! 1..1 codeBindingFixed Value Element id ServiceRequest.intent
hasValue() or (children().count() > id.count())
plan
category Σ 1..1 CodeableConcept ServiceRequest.category
hasValue() or (children().count() > id.count())
priority Σ 0..1 codeBinding ServiceRequest.priority
hasValue() or (children().count() > id.count())
doNotPerform Σ ?! 0..1 boolean ServiceRequest.doNotPerform
hasValue() or (children().count() > id.count())
code Σ 0..1 CodeableConceptBinding ServiceRequest.code
hasValue() or (children().count() > id.count())
orderDetail Σ I 0..* CodeableConcept ServiceRequest.orderDetail
supportingInformation
element.hasValue() or (children().count() > id.count())
quantity[x] Σ 0..1 ServiceRequest.quantity[x]
hasValue() or (children().count() > id.count())
quantityQuantity Quantity quantityRatio Ratio quantityRange Range subject Σ 1..1 Reference() Element id ServiceRequest.subject
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.subject.id
extension I 0..* Extension ServiceRequest.subject.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.subject.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.subject.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.subject.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.subject.identifier.id
extension I 0..* Extension ServiceRequest.subject.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.subject.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.subject.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.subject.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.subject.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.subject.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.subject.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.subject.display
hasValue() or (children().count() > id.count())
encounter Σ 0..1 Reference() ServiceRequest.encounter
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.encounter.id
extension I 0..* Extension ServiceRequest.encounter.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.encounter.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.encounter.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.encounter.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.encounter.identifier.id
extension I 0..* Extension ServiceRequest.encounter.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.encounter.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.encounter.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.encounter.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.encounter.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.encounter.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.encounter.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.encounter.display
hasValue() or (children().count() > id.count())
occurrence[x] Σ 0..1 ServiceRequest.occurrence[x]
hasValue() or (children().count() > id.count())
occurrencePeriod Period Data type asNeeded[x] Σ 0..1 ServiceRequest.asNeeded[x]
hasValue() or (children().count() > id.count())
asNeededBoolean boolean asNeededCodeableConcept CodeableConcept authoredOn Σ 1..1 dateTime Element id ServiceRequest.authoredOn
hasValue() or (children().count() > id.count())
requester Σ 0..1 Reference( | | | | | ) ServiceRequest.requester
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.requester.id
extension I 0..* Extension ServiceRequest.requester.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.requester.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.requester.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.requester.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.requester.identifier.id
extension I 0..* Extension ServiceRequest.requester.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.requester.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.requester.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.requester.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.requester.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.requester.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.requester.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.requester.display
hasValue() or (children().count() > id.count())
performerType Σ 0..1 CodeableConcept ServiceRequest.performerType
hasValue() or (children().count() > id.count())
performer Σ 0..* Reference( | | | | | | | ) Element id ServiceRequest.performer
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.performer.id
extension I 0..* Extension ServiceRequest.performer.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.performer.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.performer.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.performer.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.performer.identifier.id
extension I 0..* Extension ServiceRequest.performer.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.performer.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.performer.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.performer.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.performer.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.performer.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.performer.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.performer.display
hasValue() or (children().count() > id.count())
locationCode Σ 0..* CodeableConcept ServiceRequest.locationCode
hasValue() or (children().count() > id.count())
locationReference Σ 0..* Reference() ServiceRequest.locationReference
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.locationReference.id
extension I 0..* Extension ServiceRequest.locationReference.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.locationReference.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.locationReference.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.locationReference.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.locationReference.identifier.id
extension I 0..* Extension ServiceRequest.locationReference.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.locationReference.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.locationReference.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.locationReference.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.locationReference.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.locationReference.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.locationReference.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.locationReference.display
hasValue() or (children().count() > id.count())
reasonCode Σ 0..* CodeableConceptBinding ServiceRequest.reasonCode
supportingInfo
.CodeableConcept.text
element if the data is free (uncoded) text as shown in the CT Scan example.hasValue() or (children().count() > id.count())
reasonReference Σ 0..* Reference( | | | ) ServiceRequest.reasonReference
supportingInfo
.DiagnosticReport.conclusion
and/or DiagnosticReport.conclusionCode
. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode
if the data is free (uncoded) text as shown in the CT Scan example.hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.reasonReference.id
extension I 0..* Extension ServiceRequest.reasonReference.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.reasonReference.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.reasonReference.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.reasonReference.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.reasonReference.identifier.id
extension I 0..* Extension ServiceRequest.reasonReference.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.reasonReference.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.reasonReference.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.reasonReference.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.reasonReference.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.reasonReference.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.reasonReference.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.reasonReference.display
hasValue() or (children().count() > id.count())
insurance 0..* Reference(Coverage | ClaimResponse) ServiceRequest.insurance
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.insurance.id
extension I 0..* Extension ServiceRequest.insurance.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.insurance.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.insurance.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.insurance.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.insurance.identifier.id
extension I 0..* Extension ServiceRequest.insurance.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.insurance.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.insurance.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.insurance.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.insurance.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.insurance.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.insurance.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.insurance.display
hasValue() or (children().count() > id.count())
supportingInfo 0..* Reference(Resource) ServiceRequest.supportingInfo
instructions
element.hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.supportingInfo.id
extension I 0..* Extension ServiceRequest.supportingInfo.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.supportingInfo.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.supportingInfo.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.supportingInfo.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.supportingInfo.identifier.id
extension I 0..* Extension ServiceRequest.supportingInfo.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.supportingInfo.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.supportingInfo.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.supportingInfo.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.supportingInfo.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.supportingInfo.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.supportingInfo.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.supportingInfo.display
hasValue() or (children().count() > id.count())
specimen Σ 0..* Reference() ServiceRequest.specimen
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.specimen.id
extension I 0..* Extension ServiceRequest.specimen.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.specimen.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.specimen.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.specimen.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.specimen.identifier.id
extension I 0..* Extension ServiceRequest.specimen.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.specimen.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.specimen.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.specimen.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.specimen.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.specimen.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.specimen.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.specimen.display
hasValue() or (children().count() > id.count())
bodySite Σ 0..* CodeableConceptBinding ServiceRequest.bodySite
hasValue() or (children().count() > id.count())
note 0..* Annotation ServiceRequest.note
hasValue() or (children().count() > id.count())
patientInstruction Σ 0..1 string ServiceRequest.patientInstruction
hasValue() or (children().count() > id.count())
relevantHistory 0..* Reference() ServiceRequest.relevantHistory
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.relevantHistory.id
extension I 0..* Extension ServiceRequest.relevantHistory.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string ServiceRequest.relevantHistory.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding ServiceRequest.relevantHistory.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier ServiceRequest.relevantHistory.identifier
hasValue() or (children().count() > id.count())
id 0..1 string ServiceRequest.relevantHistory.identifier.id
extension I 0..* Extension ServiceRequest.relevantHistory.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding ServiceRequest.relevantHistory.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding ServiceRequest.relevantHistory.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri ServiceRequest.relevantHistory.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string ServiceRequest.relevantHistory.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period ServiceRequest.relevantHistory.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() ServiceRequest.relevantHistory.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string ServiceRequest.relevantHistory.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
ServiceRequest
https://simplifier.net/nhsbookingandreferrals/barsservicerequestrequestcasetransfer
1..1
ServiceRequest.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
236bb75d-90ef-461f-b71e-fde7f899802c
ServiceRequest.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
0..1
ServiceRequest.meta.profile
This MUST be populated with the structure definition for BaRSServiceRequest-request-referral
MUST
0..1
https://fhir.nhs.uk/StructureDefinition/BARSServiceRequest-request-referral
ServiceRequest.meta.lastUpdated
All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
0..1
2023-03-08T12:01:08.4677672+00:00
ServiceRequest.basedOn
MUST
0..*
ServiceRequest.basedOnreference
This MUST be populated with a reference to the CarePlan resource
MUST
0..1
urn:uuid:236bb75d-90ef-461f-b71e-fde7f899802c
ServiceRequest.status
This MUST be populated with one of three values: 'active', 'revoked' or 'entered-in-error'. 'revoked' is used when a SR is cancelled while 'entered-in-error' is used when sent to the wrong endpoint and needs to be removed.
MUST
1..1
active
ServiceRequest.intent
This MUST be populated with 'plan' - FIXED VALUE
MUST
1..1
plan
ServiceRequest.category
MUST
1..1
ServiceRequest.category.coding
BaRS Referral type
MUST
0..*
ServiceRequest.category.coding.system
This MUST be populated with CodeSystem 'https://fhir.nhs.uk/CodeSystem/message-category-servicerequest' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/message-category-servicerequest
ServiceRequest.category.coding.code
This MUST be populated with Code 'referral'. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-category-servicerequest'
MUST
0..1
referral
ServiceRequest.category.coding.display
This MUST be populated with Display 'Transfer of Care'. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-category-servicerequest'
MUST
0..1
Transfer of Care
ServiceRequest.category.coding
BaRS Use Case
MUST
0..*
ServiceRequest.category.coding.system
This MUST be populated with CodeSystem 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/usecases-categories-bars
ServiceRequest.category.coding.code
This MUST be populated with Code for the use-case. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars'
MUST
0..1
A1T1
ServiceRequest.category.coding.display
This MUST be populated with Display for the use-case. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars'
MUST
0..1
111 - ED
ServiceRequest.subject
Follow BaRS profile guidance for populating this element
MUST
1..1
ServiceRequest.subjectreference
This MUST be populated. Follow BaRS profile guidance for populating this element
MUST
0..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
ServiceRequest.encounter
MUST
0..1
ServiceRequest.encounter.reference
This MUST be populated with a Reference to the Encounter resource
MUST
0..1
urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
ServiceRequest.occurrencePeriod
SHOULD
0..1
ServiceRequest.occurrencePeriod.start
This SHOULD be populated. The start of the period MUST be ‘now’.
SHOULD
0..1
2023-03-08T12:01:08.4677672+00:00
ServiceRequest.occurrencePeriod.end
This SHOULD be populated with the time by which the next service provision SHOULD have started (this aligns with the disposition timeframe from Pathways)
SHOULD
0..1
2023-03-08T12:01:08.4677672+00:00
ServiceRequest.authoredOn
This MUST be populated with the date time the request transitioned to being actionable. In case it's 'blank' the date time SHOULD fall back to the submission time/system time of the SENDING system.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
ServiceRequest.requester
MUST
0..1
ServiceRequest.requester.reference
This MUST be populated with a reference to the Practitioner resource. This is the Healthcare Professional making the request. This does not strictly need to be a clinician.
MUST
0..1
urn:uuid:8c63d621-3424-4f57-8699-e8e22d32423g
ServiceRequest.performer
MUST
0..*
ServiceRequest.performer.reference
This MUST be populated with a reference to the requested HealthcareService resource
MUST
0..1
urn:uuid:8c63d621-2344-4f57-8699-e8e22d44235h
ServiceRequest.locationReference
MAY
0..*
ServiceRequest.locationReference.reference
This MAY be populated. Where used this will link to the Location resource. Location is typically used in 111 to ED when an address is not present because the patient is at a lat/long, WhatThreeWords, etc. location
MAY
0..1
urn:uuid:8c63d621-4g67-4f57-8699-e8e22d44234i
ServiceRequest.reasonCode
This will ONLY be populated in a cancellation message with the reason for cancellation
SHOULD
0..*
ServiceRequest.reasonCode.text
This SHOULD be populated. This will ONLY be populated in a cancellation message with the reason for cancellation and SHOULD only be used in conjunction with a corresponding status - revoked or entered-in-error
SHOULD
0..1
Revoked as patient has been dealt with.
ServiceRequest.supportingInfo
SHOULD
0..*
ServiceRequest.supportingInfo.reference
This SHOULD be populated with a reference to Rejected Services Questionnaire Response and/or Flag and/or the link to an Appointment (where a booking is made first in the workflow) as relative referrence. NB: All other supportingInfo reference (Safeguarding Flag, Patient Expectations and wishes etc.) must all reside under CarePlan.supportingInfo.
SHOULD
0..1
urn:uuid:65508934-c9e6-46d2-a393-af096b502daf
ServiceRequest.supportingInfo.display
This SHOULD be populated. Follow BaRS profile guidance for populating this element
SHOULD
0..1
Rejected Services - Patient Choice in Service Selection - Details
The HealthcareService the request is being made of - the Receiver The details of a healthcare service available at a location The details of a healthcare service available at a location. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. External identifiers for this item External identifiers for this item. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this HealthcareService record is in active use This flag is used to mark the record to not be used. This is not used when a center is closed for maintenance, or for holidays, the notAvailable period is to be used for this. This element is labeled as a modifier because it may be used to mark that the resource was created in error. This resource is generally assumed to be active if no value is provided for the active element Organization that provides this service The organization that provides this healthcare service. This property is recommended to be the same as the Location's managingOrganization, and if not provided should be interpreted as such. If the Location does not have a managing Organization, then this property should be populated. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Broad category of service being performed or delivered service category Identifies the broad category of service being performed or delivered. Selecting a Service Category then determines the list of relevant service types that can be selected in the primary service type. A category of the service(s) that could be provided. Type of service that may be delivered or performed service type The specific type of service that may be delivered or performed. Additional details about where the content was created (e.g. clinical specialty). Specialties handled by the HealthcareService Collection of specialties handled by the service site. This is more of a medical term. A specialty that a healthcare service may provide. Location(s) where service may be provided The location(s) where this healthcare service may be provided. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Description of service as presented to a consumer while searching Further description of the service as it would be presented to a consumer while searching. Additional description and/or any specific issues not covered elsewhere Any additional description of the service and/or any specific issues not covered by the other attributes, which can be displayed as further detail under the serviceName. Would expect that a user would not see this information on a search results, and it would only be available when viewing the complete details of the service. Extra details about the service that can't be placed in the other fields Extra details about the service that can't be placed in the other fields. Facilitates quick identification of the service If there is a photo/symbol associated with this HealthcareService, it may be included here to facilitate quick identification of the service in a list. Contacts related to the healthcare service List of contacts related to this specific healthcare service. If this is empty, then refer to the location's contacts. Location(s) service is intended for/available to The location(s) that this service is available to (not where the service is provided). The locations referenced by the coverage area can include both specific locations, including areas, and also conceptual domains too (mode = kind), such as a physical area (tri-state area) and some other attribute (covered by Example Care Organization). These types of Locations are often not managed by any specific organization. This could also include generic locations such as "in-home". Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Conditions under which service is available/offered The code(s) that detail the conditions under which the healthcare service is available/offered. The provision means being commissioned by, contractually obliged or financially sourced. Types of costings that may apply to this healthcare service, such if the service may be available for free, some discounts available, or fees apply. The code(s) that detail the conditions under which the healthcare service is available/offered. Specific eligibility requirements required to use the service Does this service have specific eligibility requirements that need to be met in order to use the service? Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Coded value for the eligibility Coded value for the eligibility. Coded values underwhich a specific service is made available. Describes the eligibility conditions for the service Describes the eligibility conditions for the service. The description of service eligibility should, in general, not exceed one or two paragraphs. It should be sufficient for a prospective consumer to determine if they are likely to be eligible or not. Where eligibility requirements and conditions are complex, it may simply be noted that an eligibility assessment is required. Where eligibility is determined by an outside source, such as an Act of Parliament, this should be noted, preferably with a reference to a commonly available copy of the source document such as a web page. Programs that this service is applicable to Programs that this service is applicable to. Programs are often defined externally to an Organization, commonly by governments; e.g. Home and Community Care Programs, Homeless Program, …. Government or local programs that this service applies to. Collection of characteristics (attributes) Collection of characteristics (attributes). These could be such things as is wheelchair accessible. A custom attribute that could be provided at a service (e.g. Wheelchair accessibiliy). The language that this service is offered in Some services are specifically made available in multiple languages, this property permits a directory to declare the languages this is offered in. Typically this is only provided where a service operates in communities with mixed languages used. When using this property it indicates that the service is available with this language, it is not derived from the practitioners, and not all are required to use this language, just that this language is available while scheduling. A ValueSet that identifies the language used by a person. Ways that the service accepts referrals Ways that the service accepts referrals, if this is not provided then it is implied that no referral is required. The methods of referral can be used when referring to a specific HealthCareService resource. If an appointment is required for access to this service Indicates whether or not a prospective consumer will require an appointment for a particular service at a site to be provided by the Organization. Indicates if an appointment is required for access to this service. Times the Service Site is available A collection of times that the Service Site is available. More detailed availability information may be provided in associated Schedule/Slot resources. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. mon | tue | wed | thu | fri | sat | sun Indicates which days of the week are available between the start and end Times. The days of the week. Always available? e.g. 24 hour service Is this always available? (hence times are irrelevant) e.g. 24 hour service. Opening time of day (ignored if allDay = true) The opening time of day. Note: If the AllDay flag is set, then this time is ignored. The time zone is expected to be for where this HealthcareService is provided at. Closing time of day (ignored if allDay = true) The closing time of day. Note: If the AllDay flag is set, then this time is ignored. The time zone is expected to be for where this HealthcareService is provided at. Not available during this time due to provided reason The HealthcareService is not available during this period of time due to the provided reason. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Reason presented to the user explaining why time not available The reason that can be presented to the user as to why this time is not available. Service not available from this date Service is not available (seasonally or for a public holiday) from this date. Description of availability exceptions 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. Technical endpoints providing access to electronic services operated for the healthcare service Technical endpoints providing access to services operated for the specific healthcare services defined at this resource. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.> Healthcare Service
UKCoreHealthcareService (HealthcareService) I HealthcareService HealthcareService
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string HealthcareService.id
meta Σ 0..1 Meta HealthcareService.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri HealthcareService.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding HealthcareService.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative HealthcareService.text
hasValue() or (children().count() > id.count())
contained 0..* Resource HealthcareService.contained
extension I 0..* Extension HealthcareService.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension HealthcareService.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier HealthcareService.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.identifier.id
extension I 0..* Extension HealthcareService.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.identifier.assigner
hasValue() or (children().count() > id.count())
active Σ ?! 0..1 boolean HealthcareService.active
hasValue() or (children().count() > id.count())
providedBy Σ 0..1 Reference() Element id HealthcareService.providedBy
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.providedBy.id
extension I 0..* Extension HealthcareService.providedBy.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string HealthcareService.providedBy.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding HealthcareService.providedBy.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier HealthcareService.providedBy.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.providedBy.identifier.id
extension I 0..* Extension HealthcareService.providedBy.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.providedBy.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.providedBy.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.providedBy.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.providedBy.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.providedBy.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.providedBy.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string HealthcareService.providedBy.display
hasValue() or (children().count() > id.count())
category Σ 0..* CodeableConcept HealthcareService.category
hasValue() or (children().count() > id.count())
type Σ 0..* CodeableConcept HealthcareService.type
hasValue() or (children().count() > id.count())
specialty Σ 0..* CodeableConceptBinding HealthcareService.specialty
hasValue() or (children().count() > id.count())
location Σ 0..* Reference() Element id HealthcareService.location
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.location.id
extension I 0..* Extension HealthcareService.location.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string HealthcareService.location.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding HealthcareService.location.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier HealthcareService.location.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.location.identifier.id
extension I 0..* Extension HealthcareService.location.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.location.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.location.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.location.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.location.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.location.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.location.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string HealthcareService.location.display
hasValue() or (children().count() > id.count())
name Σ 0..1 string HealthcareService.name
hasValue() or (children().count() > id.count())
comment Σ 0..1 string HealthcareService.comment
hasValue() or (children().count() > id.count())
extraDetails 0..1 markdown HealthcareService.extraDetails
hasValue() or (children().count() > id.count())
photo Σ 0..1 Attachment HealthcareService.photo
hasValue() or (children().count() > id.count())
telecom 0..* ContactPoint HealthcareService.telecom
hasValue() or (children().count() > id.count())
coverageArea 0..* Reference() Element id HealthcareService.coverageArea
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.coverageArea.id
extension I 0..* Extension HealthcareService.coverageArea.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string HealthcareService.coverageArea.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding HealthcareService.coverageArea.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier HealthcareService.coverageArea.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.coverageArea.identifier.id
extension I 0..* Extension HealthcareService.coverageArea.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.coverageArea.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.coverageArea.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.coverageArea.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.coverageArea.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.coverageArea.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.coverageArea.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string HealthcareService.coverageArea.display
hasValue() or (children().count() > id.count())
serviceProvisionCode 0..* CodeableConcept HealthcareService.serviceProvisionCode
hasValue() or (children().count() > id.count())
eligibility 0..* BackboneElement HealthcareService.eligibility
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.eligibility.id
extension I 0..* Extension HealthcareService.eligibility.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension HealthcareService.eligibility.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
code 0..1 CodeableConcept HealthcareService.eligibility.code
hasValue() or (children().count() > id.count())
comment 0..1 markdown HealthcareService.eligibility.comment
hasValue() or (children().count() > id.count())
program 0..* CodeableConcept HealthcareService.program
hasValue() or (children().count() > id.count())
characteristic 0..* CodeableConcept HealthcareService.characteristic
hasValue() or (children().count() > id.count())
communication 0..* CodeableConceptBinding Element id HealthcareService.communication
hasValue() or (children().count() > id.count())
referralMethod 0..* CodeableConcept HealthcareService.referralMethod
hasValue() or (children().count() > id.count())
appointmentRequired 0..1 boolean HealthcareService.appointmentRequired
hasValue() or (children().count() > id.count())
availableTime 0..* BackboneElement HealthcareService.availableTime
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.availableTime.id
extension I 0..* Extension HealthcareService.availableTime.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension HealthcareService.availableTime.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
daysOfWeek 0..* codeBinding HealthcareService.availableTime.daysOfWeek
hasValue() or (children().count() > id.count())
allDay 0..1 boolean HealthcareService.availableTime.allDay
hasValue() or (children().count() > id.count())
availableStartTime 0..1 time HealthcareService.availableTime.availableStartTime
hasValue() or (children().count() > id.count())
availableEndTime 0..1 time HealthcareService.availableTime.availableEndTime
hasValue() or (children().count() > id.count())
notAvailable 0..* BackboneElement HealthcareService.notAvailable
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.notAvailable.id
extension I 0..* Extension HealthcareService.notAvailable.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension HealthcareService.notAvailable.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
description 1..1 string HealthcareService.notAvailable.description
hasValue() or (children().count() > id.count())
during 0..1 Period HealthcareService.notAvailable.during
hasValue() or (children().count() > id.count())
availabilityExceptions 0..1 string HealthcareService.availabilityExceptions
hasValue() or (children().count() > id.count())
endpoint 0..* Reference(Endpoint) HealthcareService.endpoint
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.endpoint.id
extension I 0..* Extension HealthcareService.endpoint.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string HealthcareService.endpoint.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding HealthcareService.endpoint.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier HealthcareService.endpoint.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.endpoint.identifier.id
extension I 0..* Extension HealthcareService.endpoint.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.endpoint.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.endpoint.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.endpoint.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.endpoint.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.endpoint.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.endpoint.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string HealthcareService.endpoint.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
HealthcareService
https://simplifier.net/hl7fhirukcorer4/ukcore-healthcareservice
1..1
HealthcareService.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
1..1
1801e180-e6a1-4753-8a55-ab2d1cff6549
HealthcareService.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
HealthcareService.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-HealthcareService
HealthcareService.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
HealthcareService.identifier
MUST
0..*
HealthcareService.identifier.system
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
https://system.supplier.co.uk/My/Healthcare/Services
HealthcareService.identifier.value
This MUST be populated with the receiving HealthcareService identifier e.g ODS code
MUST
0..1
100
HealthcareService.active
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
HealthcareService.providedBy
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
HealthcareService.providedBy.reference
link to the Organisation the request is being made of
MUST
0..1
HealthcareService.location
MAY
0..*
HealthcareService.location.reference
Follow UK Core guidance for populating this element
MAY
0..1
urn:uuid:860e4c37-4e36-45fb-8fca-41132cd937a5
HealthcareService.name
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
Healthcare Service Name
In this interaction this resource represents the sender’s encounter. Each Organisation within the patient’s journey will create a new encounter (Case). These Encounters are linked through the JourneyID which is unchanged throughout the patient’s Journey. An interaction during which services are provided to the patient Visit An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) An extension to support the method by which an individual was admitted into hospital. extensions, user content This extension has been developed to demonstrate the representation of the method by which a patient was admitted to hospital. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AdmissionMethod An extension to support the method of discharge from a hospital. extensions, user content This extension has been developed to demonstrate the representation of the method by which a patient was discharged from hospital. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DischargeMethod An extension to support the status of an individual on discharge from an Emergency Care Department. extensions, user content This extension has been developed to demonstrate the representation of the status of a patient on discharge from an Emergency Care Department. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EmergencyCareDischargeStatus Information relating to a patient's legal status on admission or discharge. extensions, user content Information relating to a patient's legal status on admission or discharge. 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. Extension(Complex) https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-LegalStatus An extension to support the outcome of an Outpatient attendance. extensions, user content This extension has been developed to demonstrate the representation of the outcome of an Outpatient attendance. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OutcomeOfAttendance Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Identifier(s) by which this encounter is known Identifier(s) by which this encounter is known. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. planned | arrived | triaged | in-progress | onleave | finished | cancelled + planned | arrived | triaged | in-progress | onleave | finished | cancelled +. Note that internal business rules will determine the appropriate transitions that may occur between statuses (and also classes). Current state of the encounter. List of past encounter statuses The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them. The current status is always found in the current version of the resource, not the status history. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. planned | arrived | triaged | in-progress | onleave | finished | cancelled + planned | arrived | triaged | in-progress | onleave | finished | cancelled +. Current state of the encounter. The time that the episode was in the specified status The time that the episode was in the specified status. Classification of patient encounter Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations. Classification of the encounter. List of past encounter classes The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. inpatient | outpatient | ambulatory | emergency + inpatient | outpatient | ambulatory | emergency +. Classification of the encounter. The time that the episode was in the specified class The time that the episode was in the specified class. Specific type of encounter Specific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation). Since there are many ways to further classify encounters, this element is 0..*. A code from the SNOMED Clinical Terminology UK coding system that describes an encounter between a care professional and the patient (or patient's record). Specific type of service Broad categorization of the service that is to be provided (e.g. cardiology). Any code from the SNOMED CT UK Refset with fully specified name 'Services simple reference set (foundation metadata concept)' with Refset Id 1127531000000102. Indicates the urgency of the encounter Indicates the urgency of the encounter. Indicates the urgency of the encounter. The patient or group present at the encounter patient The patient or group present at the encounter. While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Episode(s) of care that this encounter should be recorded against Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The ServiceRequest that initiated this encounter incomingReferral The request this encounter satisfies (e.g. incoming referral or procedure request). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. List of participants involved in the encounter The list of people responsible for providing the service. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Role of participant in encounter Role of participant in encounter. The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc. Role of participant in encounter. Period of time during the encounter that the participant participated The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period. Persons involved in the encounter other than the patient Persons involved in the encounter other than the patient. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The appointment that scheduled this encounter The appointment that scheduled this encounter. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The start and end time of the encounter The start and end time of the encounter. If not (yet) known, the end of the Period may be omitted. Quantity of time the encounter lasted (less time absent) Quantity of time the encounter lasted. This excludes the time during leaves of absence. May differ from the time the Encounter.period lasted because of leave of absence. Coded reason the encounter takes place Indication, Admission diagnosis Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reason why the encounter takes place. Reason the encounter takes place (reference) Indication, Admission diagnosis Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reference( | | | ImmunizationRecommendation) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The list of diagnoses relevant to this encounter The list of diagnoses relevant to this encounter. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The diagnosis or procedure relevant to the encounter Admission diagnosis, discharge diagnosis, indication Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure. For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis). Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …). The type of diagnosis this condition represents. Ranking of the diagnosis (for each role type) Ranking of the diagnosis (for each role type). The set of accounts that may be used for billing for this Encounter The set of accounts that may be used for billing for this Encounter. The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Details about the admission to a healthcare service Details about the admission to a healthcare service. An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included. The duration recorded in the period of this encounter covers the entire scope of this hospitalization record. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Pre-admission identifier Pre-admission identifier. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. The location/organization from which the patient came before admission The location/organization from which the patient came before admission. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. From where patient was admitted (physician referral, transfer) From where patient was admitted (physician referral, transfer). The source of admission to a Hospital Provider Spell or a Nursing Episode when the Patient is in a Hospital Site or a Care Home. The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Whether this hospitalization is a readmission and why if known. The reason for re-admission of this hospitalization encounter. Diet preferences reported by the patient Diet preferences reported by the patient. Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter. For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive). Medical, cultural or ethical food preferences to help with catering requirements. Special courtesies (VIP, board member) Special courtesies (VIP, board member). Special courtesies. Wheelchair, translator, stretcher, etc. Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things. Special arrangements. Location/organization to which the patient is discharged Location/organization to which the patient is discharged. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Category or kind of location after discharge Category or kind of location after discharge. The destination of a Patient on completion of a Hospital Provider Spell, or a note that the Patient died or was a still birth. List of locations where the patient has been List of locations where the patient has been during this encounter. Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual". Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Location the encounter takes place The location where the encounter takes place. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. planned | active | reserved | completed The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time. When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed. The status of the location. The physical type of the location (usually the level in the location hierachy - bed room ward etc.) This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query. This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query. There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario. A set of codes that define the physical type of location where an encounter takes place. Time period during which the patient was present at the location Time period during which the patient was present at the location. The organization (facility) responsible for this encounter The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Another Encounter this encounter is part of Another Encounter of which this encounter is a part of (administratively or in time). This is also used for associating a child's encounter back to the mother's encounter. Refer to the Notes section in the Patient resource for further details. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
> Encounter
For an incident with multiple patients, each patient would have its own encounterUKCoreEncounter (Encounter) I Encounter Encounter
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Encounter.id
meta Σ 0..1 Meta Encounter.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Encounter.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Encounter.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Encounter.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Encounter.contained
extension I 0..* Extension Element id Encounter.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
admissionMethod I 0..1 Extension(CodeableConcept) Element id Encounter.extension:admissionMethod
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
dischargeMethod I 0..1 Extension(CodeableConcept) Element id Encounter.extension:dischargeMethod
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
emergencyCareDischargeStatus I 0..1 Extension(CodeableConcept) Element id Encounter.extension:emergencyCareDischargeStatus
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
legalStatus I 0..* Extension(Complex) Element id Encounter.extension:legalStatus
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
OutcomeOfAttendance I 0..1 Extension(CodeableConcept) Element id Encounter.extension:OutcomeOfAttendance
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Encounter.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Encounter.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.identifier.id
extension I 0..* Extension Encounter.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.identifier.assigner
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding Encounter.status
hasValue() or (children().count() > id.count())
statusHistory 0..* BackboneElement Encounter.statusHistory
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.statusHistory.id
extension I 0..* Extension Encounter.statusHistory.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Encounter.statusHistory.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
status 1..1 codeBinding Encounter.statusHistory.status
hasValue() or (children().count() > id.count())
period 1..1 Period Encounter.statusHistory.period
hasValue() or (children().count() > id.count())
class Σ 1..1 CodingBinding Encounter.class
hasValue() or (children().count() > id.count())
classHistory 0..* BackboneElement Encounter.classHistory
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.classHistory.id
extension I 0..* Extension Encounter.classHistory.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Encounter.classHistory.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
class 1..1 CodingBinding Encounter.classHistory.class
hasValue() or (children().count() > id.count())
period 1..1 Period Encounter.classHistory.period
hasValue() or (children().count() > id.count())
type Σ 0..* CodeableConceptBinding Element id Encounter.type
hasValue() or (children().count() > id.count())
serviceType Σ 0..1 CodeableConceptBinding Element id Encounter.serviceType
hasValue() or (children().count() > id.count())
priority 0..1 CodeableConcept Encounter.priority
hasValue() or (children().count() > id.count())
subject Σ 0..1 Reference(Group | ) Element id Encounter.subject
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.subject.id
extension I 0..* Extension Encounter.subject.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.subject.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.subject.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.subject.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.subject.identifier.id
extension I 0..* Extension Encounter.subject.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.subject.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.subject.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.subject.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.subject.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.subject.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.subject.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.subject.display
hasValue() or (children().count() > id.count())
episodeOfCare Σ 0..* Reference() Element id Encounter.episodeOfCare
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.episodeOfCare.id
extension I 0..* Extension Encounter.episodeOfCare.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.episodeOfCare.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.episodeOfCare.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.episodeOfCare.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.episodeOfCare.identifier.id
extension I 0..* Extension Encounter.episodeOfCare.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.episodeOfCare.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.episodeOfCare.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.episodeOfCare.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.episodeOfCare.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.episodeOfCare.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.episodeOfCare.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.episodeOfCare.display
hasValue() or (children().count() > id.count())
basedOn 0..* Reference() Element id Encounter.basedOn
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.basedOn.id
extension I 0..* Extension Encounter.basedOn.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.basedOn.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.basedOn.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.basedOn.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.basedOn.identifier.id
extension I 0..* Extension Encounter.basedOn.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.basedOn.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.basedOn.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.basedOn.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.basedOn.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.basedOn.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.basedOn.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.basedOn.display
hasValue() or (children().count() > id.count())
participant Σ 0..* BackboneElement Encounter.participant
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.participant.id
extension I 0..* Extension Encounter.participant.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Encounter.participant.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
type Σ 0..* CodeableConceptBinding Encounter.participant.type
hasValue() or (children().count() > id.count())
period 0..1 Period Encounter.participant.period
hasValue() or (children().count() > id.count())
individual Σ 0..1 Reference( | | ) Element id Encounter.participant.individual
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.participant.individual.id
extension I 0..* Extension Encounter.participant.individual.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.participant.individual.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.participant.individual.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.participant.individual.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.participant.individual.identifier.id
extension I 0..* Extension Encounter.participant.individual.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.participant.individual.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.participant.individual.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.participant.individual.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.participant.individual.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.participant.individual.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.participant.individual.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.participant.individual.display
hasValue() or (children().count() > id.count())
appointment Σ 0..* Reference(Appointment) Encounter.appointment
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.appointment.id
extension I 0..* Extension Encounter.appointment.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.appointment.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.appointment.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.appointment.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.appointment.identifier.id
extension I 0..* Extension Encounter.appointment.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.appointment.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.appointment.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.appointment.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.appointment.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.appointment.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.appointment.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.appointment.display
hasValue() or (children().count() > id.count())
period 0..1 Period Encounter.period
hasValue() or (children().count() > id.count())
length 0..1 Duration Encounter.length
hasValue() or (children().count() > id.count())
reasonCode Σ 0..* CodeableConceptBinding Encounter.reasonCode
hasValue() or (children().count() > id.count())
reasonReference Σ 0..* Reference( | | | ImmunizationRecommendation) Element id Encounter.reasonReference
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.reasonReference.id
extension I 0..* Extension Encounter.reasonReference.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.reasonReference.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.reasonReference.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.reasonReference.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.reasonReference.identifier.id
extension I 0..* Extension Encounter.reasonReference.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.reasonReference.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.reasonReference.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.reasonReference.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.reasonReference.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.reasonReference.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.reasonReference.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.reasonReference.display
hasValue() or (children().count() > id.count())
diagnosis Σ 0..* BackboneElement Element id Encounter.diagnosis
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.diagnosis.id
extension I 0..* Extension Encounter.diagnosis.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Encounter.diagnosis.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
condition Σ 1..1 Reference( | ) Element id Encounter.diagnosis.condition
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.diagnosis.condition.id
extension I 0..* Extension Encounter.diagnosis.condition.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.diagnosis.condition.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.diagnosis.condition.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.diagnosis.condition.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.diagnosis.condition.identifier.id
extension I 0..* Extension Encounter.diagnosis.condition.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.diagnosis.condition.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.diagnosis.condition.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.diagnosis.condition.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.diagnosis.condition.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.diagnosis.condition.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.diagnosis.condition.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.diagnosis.condition.display
hasValue() or (children().count() > id.count())
use 0..1 CodeableConceptBinding Encounter.diagnosis.use
hasValue() or (children().count() > id.count())
rank 0..1 positiveInt Encounter.diagnosis.rank
hasValue() or (children().count() > id.count())
account 0..* Reference(Account) Encounter.account
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.account.id
extension I 0..* Extension Encounter.account.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.account.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.account.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.account.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.account.identifier.id
extension I 0..* Extension Encounter.account.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.account.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.account.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.account.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.account.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.account.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.account.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.account.display
hasValue() or (children().count() > id.count())
hospitalization 0..1 BackboneElement Encounter.hospitalization
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.hospitalization.id
extension I 0..* Extension Encounter.hospitalization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Encounter.hospitalization.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
preAdmissionIdentifier 0..1 Identifier Encounter.hospitalization.preAdmissionIdentifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.hospitalization.preAdmissionIdentifier.id
extension I 0..* Extension Encounter.hospitalization.preAdmissionIdentifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.hospitalization.preAdmissionIdentifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.hospitalization.preAdmissionIdentifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.hospitalization.preAdmissionIdentifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.hospitalization.preAdmissionIdentifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.hospitalization.preAdmissionIdentifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.hospitalization.preAdmissionIdentifier.assigner
hasValue() or (children().count() > id.count())
origin 0..1 Reference( | ) Element id Encounter.hospitalization.origin
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.hospitalization.origin.id
extension I 0..* Extension Encounter.hospitalization.origin.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.hospitalization.origin.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.hospitalization.origin.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.hospitalization.origin.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.hospitalization.origin.identifier.id
extension I 0..* Extension Encounter.hospitalization.origin.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.hospitalization.origin.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.hospitalization.origin.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.hospitalization.origin.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.hospitalization.origin.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.hospitalization.origin.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.hospitalization.origin.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.hospitalization.origin.display
hasValue() or (children().count() > id.count())
admitSource 0..1 CodeableConceptBinding Element id Encounter.hospitalization.admitSource
hasValue() or (children().count() > id.count())
reAdmission 0..1 CodeableConcept Encounter.hospitalization.reAdmission
hasValue() or (children().count() > id.count())
dietPreference 0..* CodeableConcept Encounter.hospitalization.dietPreference
hasValue() or (children().count() > id.count())
specialCourtesy 0..* CodeableConceptBinding Encounter.hospitalization.specialCourtesy
hasValue() or (children().count() > id.count())
specialArrangement 0..* CodeableConceptBinding Encounter.hospitalization.specialArrangement
hasValue() or (children().count() > id.count())
destination 0..1 Reference( | ) Element id Encounter.hospitalization.destination
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.hospitalization.destination.id
extension I 0..* Extension Encounter.hospitalization.destination.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.hospitalization.destination.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.hospitalization.destination.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.hospitalization.destination.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.hospitalization.destination.identifier.id
extension I 0..* Extension Encounter.hospitalization.destination.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.hospitalization.destination.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.hospitalization.destination.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.hospitalization.destination.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.hospitalization.destination.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.hospitalization.destination.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.hospitalization.destination.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.hospitalization.destination.display
hasValue() or (children().count() > id.count())
dischargeDisposition 0..1 CodeableConceptBinding Element id Encounter.hospitalization.dischargeDisposition
hasValue() or (children().count() > id.count())
location 0..* BackboneElement Encounter.location
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.location.id
extension I 0..* Extension Encounter.location.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Encounter.location.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
location 1..1 Reference() Element id Encounter.location.location
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.location.location.id
extension I 0..* Extension Encounter.location.location.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.location.location.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.location.location.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.location.location.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.location.location.identifier.id
extension I 0..* Extension Encounter.location.location.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.location.location.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.location.location.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.location.location.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.location.location.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.location.location.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.location.location.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.location.location.display
hasValue() or (children().count() > id.count())
status 0..1 codeBinding Encounter.location.status
hasValue() or (children().count() > id.count())
physicalType 0..1 CodeableConceptBinding Element id Encounter.location.physicalType
hasValue() or (children().count() > id.count())
period 0..1 Period Encounter.location.period
hasValue() or (children().count() > id.count())
serviceProvider 0..1 Reference() Element id Encounter.serviceProvider
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.serviceProvider.id
extension I 0..* Extension Encounter.serviceProvider.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.serviceProvider.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.serviceProvider.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.serviceProvider.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.serviceProvider.identifier.id
extension I 0..* Extension Encounter.serviceProvider.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.serviceProvider.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.serviceProvider.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.serviceProvider.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.serviceProvider.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.serviceProvider.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.serviceProvider.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.serviceProvider.display
hasValue() or (children().count() > id.count())
partOf 0..1 Reference() Element id Encounter.partOf
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.partOf.id
extension I 0..* Extension Encounter.partOf.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Encounter.partOf.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Encounter.partOf.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Encounter.partOf.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Encounter.partOf.identifier.id
extension I 0..* Extension Encounter.partOf.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Encounter.partOf.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Encounter.partOf.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Encounter.partOf.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Encounter.partOf.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Encounter.partOf.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Encounter.partOf.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Encounter.partOf.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
Encounter
https://simplifier.net/hl7fhirukcorer4/ukcore-encounter
1..1
Encounter.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
236bb75d-90ef-461f-b71e-fde7f899802c
Encounter.meta
This MUST be populated with https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Encounter.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Encounter
Encounter.meta.lastUpdated
All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Encounter.Identifier
SHOULD be the human readable identifier of the encounter.
SHOULD
0..*
Encounter.status
This MUST be populated with 'finished' or 'triaged'.
MUST
1..1
finished
Encounter.class
MUST
1..1
Encounter.class.system
This MUST be populated with CodeSystem 'http://terminology.hl7.org/CodeSystem/v3-ActCode' - FIXED VALUE
MUST
0..1
http://terminology.hl7.org/CodeSystem/v3-ActCode
Encounter.class.code
This MUST be populated with Code 'EMER'. See CodeSystem: 'http://terminology.hl7.org/CodeSystem/v3-ActCode' - FIXED VALUE
MUST
0..1
EMER
Encounter.class.display
This MUST be populated with Display 'emergency'. See CodeSystem: 'http://terminology.hl7.org/CodeSystem/v3-ActCode' - FIXED VALUE
MUST
0..1
emergency
Encounter.subject
MUST
0..1
Encounter.subject.reference
This MUST be populated with a reference to the Patient resource.
MUST
1..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
Encounter.episodeOfCare
MUST
0..*
Encounter.episodeOfCare.reference
This MUST be populated with the Journey ID which links all encounters within the patient’s journey. This MUST be created at the patient’s first contact and passed in all subsequent referrals.
MUST
1..1
9589fb37-87a2-48d8-968f-b371429208a8
Encounter.period
SHOULD
0..1
Encounter.period.start
This SHOULD be populated with the time the contact with the practitioner was established. This SHOULD be the contact immediately prior to the referral being sent.
SHOULD
0..1
2023-03-08T12:01:08.4677672+00:00
In the Referral message the CarePlan resource is used to communicate triage outcome information and associated clinical information. For NHS Pathways triage outcomes the CarePlan.activity.outcomeCodableConcept MUST include the system, code and display for the following: Pathways Symptom Group (SG), Pathways Symptom Discriminator (SD), Pathways Disposition (DX) code, Pathways Pathway code (PW). Healthcare plan for patient or group Care Team Describes the intention of how one or more practitioners intend to deliver care for a particular patient, group or community for a period of time, possibly limited to care for a specific condition or set of conditions. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. External Ids for this plan Business identifiers assigned to this care plan by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Allows identification of the care plan as it is known by various participating systems and in a way that remains consistent across servers. This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Instantiates FHIR protocol or definition The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan. canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) Instantiates external protocol or definition The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. Fulfills CarePlan fulfills A care plan that is fulfilled in whole or in part by this care plan. Allows tracing of the care plan and tracking whether proposals/recommendations were acted upon. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. CarePlan replaced by this CarePlan supersedes Completed or terminated care plan whose function is taken by this new care plan. Allows tracing the continuation of a therapy or administrative process instantiated through multiple care plans. The replacement could be because the initial care plan was immediately rejected (due to an issue) or because the previous care plan was completed, but the need for the action described by the care plan remains ongoing. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Part of referenced CarePlan A larger care plan of which this particular care plan is a component or step. Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. draft | active | on-hold | revoked | completed | entered-in-error | unknown Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record. Allows clinicians to determine whether the plan is actionable or not. The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the care plan. This element is labeled as a modifier because the status contains the code entered-in-error that marks the plan as not currently valid. Indicates whether the plan is currently being acted upon, represents future intentions or is now a historical record. proposal | plan | order | option Indicates the level of authority/intentionality associated with the care plan and where the care plan fits into the workflow chain. Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain. This element is labeled as a modifier because the intent alters when and how the resource is actually applicable. Codes indicating the degree of authority/intentionality associated with a care plan. Type of plan Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", "wellness plan", etc. Used for filtering what plan(s) are retrieved and displayed to different types of users. There may be multiple axes of categorization and one plan may serve multiple purposes. In some cases, this may be redundant with references to CarePlan.concern. Identifies what "kind" of plan this is to support differentiation between multiple co-existing plans; e.g. "Home health", "psychiatric", "asthma", "disease management", etc. Human-friendly name for the care plan Human-friendly name for the care plan. Summary of nature of plan A description of the scope and nature of the plan. Provides more detail than conveyed by category. Who the care plan is for patient Identifies the patient or group whose intended care is described by the plan. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Encounter created as part of The Encounter during which this CarePlan was created or to which the creation of this record is tightly associated. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. CarePlan activities conducted as a result of the care plan may well occur as part of other encounters. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Time period plan covers timing Indicates when the plan did (or is intended to) come into effect and end. Allows tracking what plan(s) are in effect at a particular time. Any activities scheduled as part of the plan should be constrained to the specified period regardless of whether the activities are planned within a single encounter/episode or across multiple encounters/episodes (e.g. the longitudinal management of a chronic condition). Date record was first recorded authoredOn Represents when this particular CarePlan record was created in the system, which is often a system-generated date. Who is the designated responsible party When populated, the author is responsible for the care plan. The care plan is attributed to the author. The author may also be a contributor. For example, an organization can be an author, but not listed as a contributor. Reference(Device | | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Who provided the content of the care plan Identifies the individual(s) or organization who provided the contents of the care plan. Collaborative care plans may have multiple contributors. Reference(Device | | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Who's involved in plan? Identifies all people and organizations who are expected to be involved in the care envisioned by this plan. Allows representation of care teams, helps scope care plan. In some cases may be a determiner of access permissions. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Health issues this plan addresses Identifies the conditions/problems/concerns/diagnoses/etc. whose management and/or mitigation are handled by this plan. Links plan to the conditions it manages. The element can identify risks addressed by the plan as well as active conditions. (The Condition resource can include things like "at risk for hypertension" or "fall risk".) Also scopes plans - multiple plans may exist addressing different concerns. When the diagnosis is related to an allergy or intolerance, the Condition and AllergyIntolerance resources can both be used. However, to be actionable for decision support, using Condition alone is not sufficient as the allergy or intolerance condition needs to be represented as an AllergyIntolerance. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Information considered as part of plan Identifies portions of the patient's record that specifically influenced the formation of the plan. These might include comorbidities, recent procedures, limitations, recent assessments, etc. Identifies barriers and other considerations associated with the care plan. Use "concern" to identify specific conditions addressed by the care plan. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Desired outcome of plan Describes the intended objective(s) of carrying out the care plan. Provides context for plan. Allows plan effectiveness to be evaluated by clinicians. Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Action to occur as part of plan Identifies a planned action to occur as part of the plan. For example, a medication to be used, lab tests to perform, self-monitoring, education, etc. Allows systems to prompt for performance of planned activities, and validate plans against best practice. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Results of the activity Identifies the outcome at the point when the status of the activity is assessed. For example, the outcome of an education activity could be patient understands (or not). Note that this should not duplicate the activity status (e.g. completed or in progress). Identifies the results of the activity. Appointment, Encounter, Procedure, etc. Details of the outcome or action resulting from the activity. The reference to an "event" resource, such as Procedure or Encounter or Observation, is the result/outcome of the activity itself. The activity can be conveyed using CarePlan.activity.detail OR using the CarePlan.activity.reference (a reference to a “request” resource). Links plan to resulting actions. The activity outcome is independent of the outcome of the related goal(s). For example, if the goal is to achieve a target body weight of 150 lbs and an activity is defined to diet, then the activity outcome could be calories consumed whereas the goal outcome is an observation for the actual body weight measured. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Comments about the activity status/progress Notes about the adherence/status/progress of the activity. Can be used to capture information about adherence, progress, concerns, etc. This element should NOT be used to describe the activity to be performed - that occurs either within the resource pointed to by activity.detail.reference or in activity.detail.description. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Individual responsible for the annotation The individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment. Reference( | | | ) When the annotation was made Indicates when this particular annotation was made. The annotation - text content (as markdown) The text of the annotation in markdown format. Activity details defined in specific resource The details of the proposed activity represented in a specific resource. Details in a form consistent with other applications and contexts of use. Standard extension exists (resource-pertainsToGoal) that allows goals to be referenced from any of the referenced resources in CarePlan.activity.reference. Reference(Appointment | CommunicationRequest | DeviceRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup | MedicationRequest) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. In-line definition of activity A simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources such as procedure etc. Details in a simple form for generic care plan systems. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Appointment | CommunicationRequest | DeviceRequest | MedicationRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription A description of the kind of resource the in-line definition of a care plan activity is representing. The CarePlan.activity.detail is an in-line definition when a resource is not referenced using CarePlan.activity.reference. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest. May determine what types of extensions are permitted. Resource types defined as part of FHIR that can be represented as in-line definitions of a care plan activity. Instantiates FHIR protocol or definition The URL pointing to a FHIR-defined protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity. Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity. canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) Instantiates external protocol or definition The URL pointing to an externally maintained protocol, guideline, questionnaire or other definition that is adhered to in whole or in part by this CarePlan activity. Allows Questionnaires that the patient (or practitioner) should fill in to fulfill the care plan activity. This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. Detail type of activity Detailed description of the type of planned activity; e.g. what lab test, what procedure, what kind of encounter. Allows matching performed to planned as well as validation against protocols. Tends to be less relevant for activities involving particular products. Codes should not convey negation - use "prohibited" instead. Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter. Why activity should be done or why activity was prohibited Provides the rationale that drove the inclusion of this particular activity as part of the plan or the reason why the activity was prohibited. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonCondition instead. Identifies why a care plan activity is needed. Can include any health condition codes as well as such concepts as "general wellness", prophylaxis, surgical preparation, etc. Why activity is needed Indicates another resource, such as the health condition(s), whose existence justifies this request and drove the inclusion of this particular activity as part of the plan. Conditions can be identified at the activity level that are not identified as reasons for the overall plan. Reference( | | | DiagnosticReport) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Goals this activity relates to Internal reference that identifies the goals that this activity is intended to contribute towards meeting. So that participants know the link explicitly. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. not-started | scheduled | in-progress | on-hold | completed | cancelled | stopped | unknown | entered-in-error Identifies what progress is being made for the specific activity. Indicates progress against the plan, whether the activity is still relevant for the plan. Some aspects of status can be inferred based on the resources linked in actionTaken. Note that "status" is only as current as the plan was most recently updated. Codes that reflect the current state of a care plan activity within its overall life cycle. Reason for current status Provides reason why the activity isn't yet started, is on hold, was cancelled, etc. Will generally not be present if status is "complete". Be sure to prompt to update this (or at least remove the existing value) if the status is changed. If true, activity is prohibiting action If true, indicates that the described activity is one that must NOT be engaged in when following the plan. If false, or missing, indicates that the described activity is one that should be engaged in when following the plan. Captures intention to not do something that may have been previously typical. This element is labeled as a modifier because it marks an activity as an activity that is not to be performed. If missing indicates that the described activity is one that should be engaged in when following the plan. When activity is to occur The period, timing or frequency upon which the described activity is to occur. Allows prompting for activities and detection of missed planned activities. Where it should happen Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc. Helps in planning of activity. May reference a specific clinical location or may identify a type of location. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Who will be responsible? Identifies who's expected to be involved in the activity. Helps in planning of activity. A performer MAY also be a participant in the care plan. Reference(HealthcareService | Device | | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. What is to be administered/supplied Identifies the food, drug or other product to be consumed or supplied in the activity. A product supplied or administered as part of a care plan activity. How to consume/day? daily dose Identifies the quantity expected to be consumed in a given day. Allows rough dose checking. How much to administer/supply/consume Identifies the quantity expected to be supplied, administered or consumed by the subject. Extra info describing activity to perform This provides a textual description of constraints on the intended activity occurrence, including relation to other activities. It may also include objectives, pre-conditions and end-conditions. Finally, it may convey specifics about the activity such as body site, method, route, etc. Comments about the plan General notes about the care plan not covered elsewhere. Used to capture information that applies to the plan as a whole that doesn't fit into discrete elements. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Individual responsible for the annotation The individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment. Reference( | | | ) When the annotation was made Indicates when this particular annotation was made. The annotation - text content (as markdown) The text of the annotation in markdown format.
> CarePlan
UKCoreCarePlan (CarePlan) I CarePlan CarePlan
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string CarePlan.id
meta Σ 0..1 Meta CarePlan.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri CarePlan.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding CarePlan.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative CarePlan.text
hasValue() or (children().count() > id.count())
contained 0..* Resource CarePlan.contained
extension I 0..* Extension CarePlan.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension CarePlan.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier CarePlan.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.identifier.id
extension I 0..* Extension CarePlan.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.identifier.assigner
hasValue() or (children().count() > id.count())
instantiatesCanonical Σ 0..* canonical(PlanDefinition | Questionnaire | Measure | ActivityDefinition | OperationDefinition) CarePlan.instantiatesCanonical
hasValue() or (children().count() > id.count())
instantiatesUri Σ 0..* uri CarePlan.instantiatesUri
hasValue() or (children().count() > id.count())
basedOn Σ 0..* Reference() Element id CarePlan.basedOn
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.basedOn.id
extension I 0..* Extension CarePlan.basedOn.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.basedOn.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.basedOn.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.basedOn.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.basedOn.identifier.id
extension I 0..* Extension CarePlan.basedOn.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.basedOn.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.basedOn.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.basedOn.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.basedOn.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.basedOn.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.basedOn.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.basedOn.display
hasValue() or (children().count() > id.count())
replaces Σ 0..* Reference() Element id CarePlan.replaces
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.replaces.id
extension I 0..* Extension CarePlan.replaces.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.replaces.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.replaces.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.replaces.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.replaces.identifier.id
extension I 0..* Extension CarePlan.replaces.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.replaces.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.replaces.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.replaces.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.replaces.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.replaces.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.replaces.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.replaces.display
hasValue() or (children().count() > id.count())
partOf Σ 0..* Reference() Element id CarePlan.partOf
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.partOf.id
extension I 0..* Extension CarePlan.partOf.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.partOf.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.partOf.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.partOf.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.partOf.identifier.id
extension I 0..* Extension CarePlan.partOf.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.partOf.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.partOf.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.partOf.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.partOf.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.partOf.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.partOf.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.partOf.display
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding CarePlan.status
hasValue() or (children().count() > id.count())
intent Σ ?! 1..1 codeBinding CarePlan.intent
hasValue() or (children().count() > id.count())
category Σ 0..* CodeableConcept CarePlan.category
hasValue() or (children().count() > id.count())
title Σ 0..1 string CarePlan.title
hasValue() or (children().count() > id.count())
description Σ 0..1 string CarePlan.description
hasValue() or (children().count() > id.count())
subject Σ 1..1 Reference(Group | ) Element id CarePlan.subject
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.subject.id
extension I 0..* Extension CarePlan.subject.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.subject.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.subject.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.subject.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.subject.identifier.id
extension I 0..* Extension CarePlan.subject.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.subject.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.subject.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.subject.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.subject.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.subject.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.subject.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.subject.display
hasValue() or (children().count() > id.count())
encounter Σ 0..1 Reference() Element id CarePlan.encounter
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.encounter.id
extension I 0..* Extension CarePlan.encounter.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.encounter.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.encounter.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.encounter.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.encounter.identifier.id
extension I 0..* Extension CarePlan.encounter.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.encounter.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.encounter.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.encounter.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.encounter.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.encounter.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.encounter.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.encounter.display
hasValue() or (children().count() > id.count())
period Σ 0..1 Period CarePlan.period
hasValue() or (children().count() > id.count())
created Σ 0..1 dateTime CarePlan.created
hasValue() or (children().count() > id.count())
author Σ 0..1 Reference(Device | | | | | | ) Element id CarePlan.author
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.author.id
extension I 0..* Extension CarePlan.author.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.author.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.author.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.author.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.author.identifier.id
extension I 0..* Extension CarePlan.author.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.author.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.author.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.author.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.author.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.author.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.author.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.author.display
hasValue() or (children().count() > id.count())
contributor 0..* Reference(Device | | | | | | ) Element id CarePlan.contributor
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.contributor.id
extension I 0..* Extension CarePlan.contributor.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.contributor.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.contributor.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.contributor.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.contributor.identifier.id
extension I 0..* Extension CarePlan.contributor.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.contributor.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.contributor.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.contributor.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.contributor.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.contributor.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.contributor.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.contributor.display
hasValue() or (children().count() > id.count())
careTeam 0..* Reference() Element id CarePlan.careTeam
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.careTeam.id
extension I 0..* Extension CarePlan.careTeam.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.careTeam.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.careTeam.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.careTeam.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.careTeam.identifier.id
extension I 0..* Extension CarePlan.careTeam.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.careTeam.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.careTeam.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.careTeam.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.careTeam.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.careTeam.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.careTeam.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.careTeam.display
hasValue() or (children().count() > id.count())
addresses Σ 0..* Reference() Element id CarePlan.addresses
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.addresses.id
extension I 0..* Extension CarePlan.addresses.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.addresses.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.addresses.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.addresses.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.addresses.identifier.id
extension I 0..* Extension CarePlan.addresses.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.addresses.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.addresses.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.addresses.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.addresses.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.addresses.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.addresses.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.addresses.display
hasValue() or (children().count() > id.count())
supportingInfo 0..* Reference(Resource) CarePlan.supportingInfo
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.supportingInfo.id
extension I 0..* Extension CarePlan.supportingInfo.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.supportingInfo.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.supportingInfo.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.supportingInfo.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.supportingInfo.identifier.id
extension I 0..* Extension CarePlan.supportingInfo.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.supportingInfo.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.supportingInfo.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.supportingInfo.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.supportingInfo.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.supportingInfo.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.supportingInfo.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.supportingInfo.display
hasValue() or (children().count() > id.count())
goal 0..* Reference(Goal) CarePlan.goal
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.goal.id
extension I 0..* Extension CarePlan.goal.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.goal.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.goal.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.goal.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.goal.identifier.id
extension I 0..* Extension CarePlan.goal.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.goal.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.goal.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.goal.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.goal.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.goal.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.goal.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.goal.display
hasValue() or (children().count() > id.count())
activity I 0..* BackboneElement CarePlan.activity
detail.empty() or reference.empty()
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.id
extension I 0..* Extension CarePlan.activity.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension CarePlan.activity.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
outcomeCodeableConcept 0..* CodeableConcept CarePlan.activity.outcomeCodeableConcept
hasValue() or (children().count() > id.count())
outcomeReference 0..* Reference(Resource) CarePlan.activity.outcomeReference
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.outcomeReference.id
extension I 0..* Extension CarePlan.activity.outcomeReference.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.activity.outcomeReference.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.activity.outcomeReference.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.activity.outcomeReference.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.outcomeReference.identifier.id
extension I 0..* Extension CarePlan.activity.outcomeReference.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.activity.outcomeReference.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.activity.outcomeReference.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.activity.outcomeReference.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.activity.outcomeReference.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.activity.outcomeReference.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.activity.outcomeReference.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.activity.outcomeReference.display
hasValue() or (children().count() > id.count())
progress 0..* Annotation CarePlan.activity.progress
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.progress.id
extension I 0..* Extension CarePlan.activity.progress.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
author[x] Σ 0..1 CarePlan.activity.progress.author[x]
hasValue() or (children().count() > id.count())
authorString string Data type authorReference Reference( | | | ) Data type time Σ 0..1 dateTime CarePlan.activity.progress.time
hasValue() or (children().count() > id.count())
text Σ 1..1 markdown CarePlan.activity.progress.text
hasValue() or (children().count() > id.count())
reference I 0..1 Reference(Appointment | CommunicationRequest | DeviceRequest | NutritionOrder | Task | ServiceRequest | VisionPrescription | RequestGroup | MedicationRequest) Element id CarePlan.activity.reference
The goal should be visible when the resource referenced by CarePlan.activity.reference is viewed independently from the CarePlan. Requests that are pointed to by a CarePlan using this element should not point to this CarePlan using the "basedOn" element. i.e. Requests that are part of a CarePlan are not "based on" the CarePlan.hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.reference.id
extension I 0..* Extension CarePlan.activity.reference.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.activity.reference.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.activity.reference.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.activity.reference.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.reference.identifier.id
extension I 0..* Extension CarePlan.activity.reference.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.activity.reference.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.activity.reference.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.activity.reference.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.activity.reference.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.activity.reference.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.activity.reference.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.activity.reference.display
hasValue() or (children().count() > id.count())
detail I 0..1 BackboneElement CarePlan.activity.detail
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.id
extension I 0..* Extension CarePlan.activity.detail.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension CarePlan.activity.detail.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
kind 0..1 codeBinding CarePlan.activity.detail.kind
hasValue() or (children().count() > id.count())
instantiatesCanonical 0..* canonical(PlanDefinition | ActivityDefinition | Questionnaire | Measure | OperationDefinition) CarePlan.activity.detail.instantiatesCanonical
hasValue() or (children().count() > id.count())
instantiatesUri 0..* uri CarePlan.activity.detail.instantiatesUri
hasValue() or (children().count() > id.count())
code 0..1 CodeableConcept CarePlan.activity.detail.code
hasValue() or (children().count() > id.count())
reasonCode 0..* CodeableConcept CarePlan.activity.detail.reasonCode
hasValue() or (children().count() > id.count())
reasonReference 0..* Reference( | | | DiagnosticReport) Element id CarePlan.activity.detail.reasonReference
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.reasonReference.id
extension I 0..* Extension CarePlan.activity.detail.reasonReference.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.activity.detail.reasonReference.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.activity.detail.reasonReference.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.activity.detail.reasonReference.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.reasonReference.identifier.id
extension I 0..* Extension CarePlan.activity.detail.reasonReference.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.activity.detail.reasonReference.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.activity.detail.reasonReference.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.activity.detail.reasonReference.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.activity.detail.reasonReference.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.activity.detail.reasonReference.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.activity.detail.reasonReference.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.activity.detail.reasonReference.display
hasValue() or (children().count() > id.count())
goal 0..* Reference(Goal) CarePlan.activity.detail.goal
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.goal.id
extension I 0..* Extension CarePlan.activity.detail.goal.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.activity.detail.goal.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.activity.detail.goal.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.activity.detail.goal.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.goal.identifier.id
extension I 0..* Extension CarePlan.activity.detail.goal.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.activity.detail.goal.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.activity.detail.goal.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.activity.detail.goal.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.activity.detail.goal.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.activity.detail.goal.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.activity.detail.goal.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.activity.detail.goal.display
hasValue() or (children().count() > id.count())
status ?! 1..1 codeBinding CarePlan.activity.detail.status
The unknown code is not to be used to convey other statuses. The unknown code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the activity.hasValue() or (children().count() > id.count())
statusReason 0..1 CodeableConcept CarePlan.activity.detail.statusReason
hasValue() or (children().count() > id.count())
doNotPerform ?! 0..1 boolean CarePlan.activity.detail.doNotPerform
hasValue() or (children().count() > id.count())
scheduled[x] 0..1 CarePlan.activity.detail.scheduled[x]
hasValue() or (children().count() > id.count())
scheduledTiming Timing scheduledPeriod Period scheduledString string location 0..1 Reference() Element id CarePlan.activity.detail.location
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.location.id
extension I 0..* Extension CarePlan.activity.detail.location.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.activity.detail.location.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.activity.detail.location.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.activity.detail.location.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.location.identifier.id
extension I 0..* Extension CarePlan.activity.detail.location.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.activity.detail.location.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.activity.detail.location.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.activity.detail.location.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.activity.detail.location.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.activity.detail.location.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.activity.detail.location.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.activity.detail.location.display
hasValue() or (children().count() > id.count())
performer 0..* Reference(HealthcareService | Device | | | | | | ) Element id CarePlan.activity.detail.performer
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.performer.id
extension I 0..* Extension CarePlan.activity.detail.performer.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string CarePlan.activity.detail.performer.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding CarePlan.activity.detail.performer.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier CarePlan.activity.detail.performer.identifier
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.activity.detail.performer.identifier.id
extension I 0..* Extension CarePlan.activity.detail.performer.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding CarePlan.activity.detail.performer.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding CarePlan.activity.detail.performer.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri CarePlan.activity.detail.performer.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string CarePlan.activity.detail.performer.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period CarePlan.activity.detail.performer.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id CarePlan.activity.detail.performer.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string CarePlan.activity.detail.performer.display
hasValue() or (children().count() > id.count())
product[x] 0..1 CarePlan.activity.detail.product[x]
hasValue() or (children().count() > id.count())
productCodeableConcept CodeableConcept Data type productReference Reference(Substance | ) Data type dailyAmount 0..1 SimpleQuantity CarePlan.activity.detail.dailyAmount
hasValue() or (children().count() > id.count())
quantity 0..1 SimpleQuantity CarePlan.activity.detail.quantity
hasValue() or (children().count() > id.count())
description 0..1 string CarePlan.activity.detail.description
hasValue() or (children().count() > id.count())
note 0..* Annotation CarePlan.note
hasValue() or (children().count() > id.count())
id 0..1 string CarePlan.note.id
extension I 0..* Extension CarePlan.note.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
author[x] Σ 0..1 CarePlan.note.author[x]
hasValue() or (children().count() > id.count())
authorString string Data type authorReference Reference( | | | ) Data type time Σ 0..1 dateTime CarePlan.note.time
hasValue() or (children().count() > id.count())
text Σ 1..1 markdown CarePlan.note.text
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
CarePlan
https://simplifier.net/hl7fhirukcorer4/ukcore-careplan
1..1
CarePlan.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
236bb75d-90ef-461f-b71e-fde7f899802c
CarePlan.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
CarePlan.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-CarePlan
CarePlan.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
CarePlan.status
This MUST be populated with ‘completed’ - FIXED VALUE
MUST
1..1
completed
CarePlan.intent
This MUST be populated with ‘plan’ - FIXED VALUE
MUST
1..1
plan
CarePlan.subject
MUST
1..1
CarePlan.subject.reference
This MUST be populated with a reference to the Patient resource
MUST
0..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
CarePlan.encounter
MUST
0..1
CarePlan.encounter.reference
This MUST be populated with a reference to the sender's Encounter resource
MUST
1..1
urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4413
CarePlan.period
MUST
0..1
CarePlan.period.start
This MUST be populated with the date/time the triage Disposition was identified
MUST
0..1
2023-03-08T12:01:08.4677672+00:00
CarePlan.supportingInfo
SHOULD
0..*
CarePlan.supportingInfo.reference
This SHOULD be populated with a reference to Safeguarding Flag etc. This MUST NOT be populated with a reference to Rejected Services Questionnaire Response and/or Flag and/or the link to an Appointment (where a booking is made first in the workflow) as relative referrence. These reference MUST go under ServiceRequest.supportingInfo
SHOULD
0..1
urn:uuid:ea37a499-245c-40e9-b0fa-df4383c4d413
CarePlan.supportingInfo.display
This SHOULD be populated. Follow BaRS profile guidance for populating this element
SHOULD
0..1
Safeguarding Concerns Flag
CarePlan.activity
This MUST be populated with the action to occur as part of the plan
MUST
0..*
CarePlan.activity.outcomeCodeableConcept
This MUST be populated with the triage outcomes
MUST
0..*
CarePlan.activity.outcomeCodeableConcept.text
This MUST be populated with the clinical narrative.
MUST
0..1
CONSULTATION SUMMARY
PRINTED ON 30/03/2022 09:53:52
CASE ID: d7e773ac-7710-42d9-849d-bf83119c3549
NHS PATHWAYS R32.1.0_internalV1 (Alpha)
PATIENT: Julie Jones
TELEPHONE:
AGE GROUP: Adult
GENDER: Female
PARTY: 1
POSTCODE: DH1 2HP
NOTES:
SKILLSET: 111 Call Handler
CALL HANDLER USER ID: sam.harris@nhs.net
PATHWAY: PW1267 - Hand or Wrist Injury, Blunt
SYMPTOM GROUP: SG1107 - Hand or Wrist Injury, Blunt
SYMPTOM DISCRIMINATOR: SD4500 - ED fracture and or dislocation
DISPOSITION: Dx02 - The individual needs to be referred to a treatment centre within 1 hour.
SELECTED CARE SERVICE: 119857, ED: University Hospital North Durham (Durham), University Hospital of North Durham, North Road, Durham, DH1 5TW0191 3332333 [...]
CarePlan.activity.outcomeCodeableConcept.coding
This SHOULD be populated with the triage outcome codes
SHOULD
0..1
CarePlan.activity.outcomeCodeableConcept.coding.system
This SHOULD be populated as follows:
* Pathways Symptom Group (SG) code use https://fhir.nhs.uk/CodeSystem/pathways-sg-codes value
* Pathways Symptom Discriminator (SD) code use https://fhir.nhs.uk/CodeSystem/pathways-sd-codes value
* Pathways Disposition (DX) code use https://fhir.nhs.uk/CodeSystem/pathways-dx-codes value
* Pathways Pathway code (PW) use https://fhir.nhs.uk/CodeSystem/pathways-pathway-codesSHOULD
0..1
https://fhir.nhs.uk/CodeSystem/sd-codes
CarePlan.activity.outcomeCodeableConcept.coding.code
This SHOULD be populated as follows:
*When you are passing an SG code this MUST be populated with the SG code
*When you are passing an SD code this MUST be populated with the SD code.
*When you are passing an Dx code this MUST be populated with the Dx code.
*When you are passing a PW code code this MUST be populated with the PW codeSHOULD
0..1
SD4500
CarePlan.activity.outcomeCodeableConcept.coding.display
This SHOULD be populated as follows:
When you are passing an SG code this MUST be populated the SG code description
When you are passing an SD code this MUST be populated the SD code description
When you are passing an Dx code this MUST be populated the Dx code descriptionSHOULD
0..1
ED fracture and or dislocation
This resource is used to communicate details about the patient who is the subject of the referral. Information about an individual or animal receiving health care services SubjectOfCare Client Resident Demographics and other administrative information about an individual or animal receiving care or other health-related services. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) The registered place of birth of the patient. extensions, user content The registered place of birth of the patient. 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. http://hl7.org/fhir/StructureDefinition/patient-birthPlace Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The registered place of birth of the patient. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). The patient's phenotypic sex at birth. extensions, user content The patient's phenotypic sex at birth. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex Post-mortem donor status. extensions, user content Flag indicating whether the patient authorized the donation of body parts after death. 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. http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Post-mortem donor status. Flag indicating whether the patient authorized the donation of body parts after death. The preferred method of contact, contact times and written communication format given by a Patient or Related Person. extensions, user content The preferred method of contact, contact times and written communication format given by a Patient or Related Person. 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. Extension(Complex) https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactPreference The patient's death notification status. extensions, user content The patient's death notification status. 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. Extension(Complex) https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeathNotificationStatus The ethnicity of the subject extensions, user content The ethnicity of the subject. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory The residential status of the patient. extensions, user content The residential status of the patient. For example if this patient is a UK resident. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ResidentialStatus The patient's professed religious affiliations extensions, user content The patient's professed religious affiliations. 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. http://hl7.org/fhir/StructureDefinition/patient-religion Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The religious affiliation of the patient The religious affiliation of the patient. v3.ReligiousAffiliation (extensible) Whether the patient needs an interpreter extensions, user content This Patient requires an interpreter to communicate healthcare information to the practitioner. The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required. http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Indicator showing whether the patient needs an interpreter Indicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. An identifier for this patient An identifier for this patient. Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) The patient's NHS number An identifier for this patient. Patients are almost always assigned specific numerical identifiers. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) NHS number verification status extensions, user content The verification/tracing status of the NHS number. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this patient's record is in active use Whether this patient record is in active use.
Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Need to be able to mark a patient record as not to be used because it was created in error. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. This resource is generally assumed to be active if no value is provided for the active element A name associated with the patient A name associated with the individual. Need to be able to track the patient by multiple names. Examples are your official name and a partner name. A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. A contact detail for the individual A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) phone | fax | email | pager | url | sms | other Telecommunications form for contact point - what communications system is required to make use of the contact. Telecommunications form for contact point. xml:id (or equivalent in JSON) unique id for the element within a resource (for internal references) Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Other contact system extensions, user content Other contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem Primitive value for code Primitive value for code System.String The actual contact point details The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. home | work | temp | old | mobile - purpose of this contact point Identifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. Specify preferred order of use (1 = highest) Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Time period when the contact point was/is in use Time period when the contact point was/is in use. male | female | other | unknown Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Needed for identification of the individual, in combination with (at least) name and birth date. The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. The gender of a person used for administrative purposes. The date of birth for the individual The date of birth for the individual. Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). xml:id (or equivalent in JSON) unique id for the element within a resource (for internal references) Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Time of day of birth. extensions, user content The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. 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. http://hl7.org/fhir/StructureDefinition/patient-birthTime Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Time of day of birth. The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. Primitive value for date The actual value System.Date Indicates if the individual is deceased or not Indicates if the individual is deceased or not. The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. An address for the individual An address for the individual May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Patient may have multiple addresses with different uses or applicable periods. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) A patient's address key and type extensions, user content A patient's address key and type. 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. Extension(Complex) https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AddressKey home | work | temp | old | billing - purpose of this address The purpose of this address. Allows an appropriate address to be chosen from a list of many. Applications can assume that an address is current unless it explicitly says that it is temporary or old. The use of an address. postal | physical | both Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). The type of an address (physical / postal). Text representation of the address Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Street name, number, direction & P.O. Box etc. This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Name of city, town etc. Municpality The name of the city, town, suburb, village or other community or delivery center. District name (aka county) County The name of the administrative area (county). District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. Sub-unit of country (abbreviations ok) Province, Territory Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Postal code for area Zip A postal code designating a region defined by the postal service. Country (e.g. can be ISO 3166 2 or 3 letter code) Country - a nation as commonly understood or generally accepted. ISO 3166 3 letter codes can be used in place of a human readable country name. Time period when address was/is in use Time period when address was/is in use. Allows addresses to be placed in historical context. Marital (civil) status of a patient This field contains a patient's most recent marital (civil) status. Most, if not all systems capture it. An indicator to identify the legal marital status of a person Whether patient is part of a multiple birth Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). Image of the patient Image of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Guidelines: A contact party (e.g. guardian, partner, friend) for the patient A contact party (e.g. guardian, partner, friend) for the patient. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Preferred ranking or order of contact applied to a contact on a patient's contact list extensions, user content The preferred ranking or order of contact applied to a contact on a patient's contact list. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank Indicator showing that a patient's contact or related person must be copied in to patient correspondence extensions, user content Extension carrying a boolean indicator showing that a patient's contact or related person must be copied in to patient correspondence. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-CopyCorrespondenceIndicator Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The kind of relationship The nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. The nature of the relationship between a patient and a contact person for that patient. A name associated with the contact person A name associated with the contact person. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. A contact detail for the person A contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) phone | fax | email | pager | url | sms | other Telecommunications form for contact point - what communications system is required to make use of the contact. Telecommunications form for contact point. xml:id (or equivalent in JSON) unique id for the element within a resource (for internal references) Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Other contact system extensions, user content Other contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem Primitive value for code Primitive value for code System.String The actual contact point details The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. home | work | temp | old | mobile - purpose of this contact point Identifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. Specify preferred order of use (1 = highest) Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Time period when the contact point was/is in use Time period when the contact point was/is in use. Address for the contact person Address for the contact person. Need to keep track where the contact person can be contacted per postal mail or visited. male | female | other | unknown Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. The gender of a person used for administrative purposes. Organization that is associated with the contact Organization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The period during which this contact person or organization is valid to be contacted relating to this patient The period during which this contact person or organization is valid to be contacted relating to this patient. A language which may be used to communicate with the patient about his or her health A language which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Proficiency level of the communication extensions, user content Proficiency level of the communication. 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. Extension(Complex) http://hl7.org/fhir/StructureDefinition/patient-proficiency Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) The proficiency level of the communication How well the patient can communicate this communication (good, poor, etc.). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The proficiency level for the communication The proficiency level for the communication. The proficiency level for the communication. The proficiency type of the communication What type of communication for the proficiency (spoken, written, etc.). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The proficiency type for the communication The proficiency type for the communication. The proficiency type for the communication. identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Value of extension Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. A ValueSet that identifies the language used by a person. A ValueSet that identifies the language used by a person. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. A ValueSet that identifies the language used by a person. Language preference indicator Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information. Patient's nominated primary care provider careProvider Patient's nominated care provider. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.
Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Organization that is the custodian of the patient record Organization that is the custodian of the patient record. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Link to another patient resource that concerns the same actual person Link to another patient resource that concerns the same actual patient. There are multiple use cases: There is no assumption that linked patient records have mutual links. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The other patient or related person resource that the link refers to The other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. replaced-by | replaces | refer | seealso The type of link between this patient resource and another patient resource. The type of link between this patient resource and another patient resource.
> Patient
It also includes contact information for third parties when required.UKCorePatient (Patient) I Patient Patient
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Patient.id
meta Σ 0..1 Meta Patient.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Patient.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Patient.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Patient.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Patient.contained
extension I 0..* Extension Element id Patient.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
birthPlace I 0..1 Extension(Address) Element id Patient.extension:birthPlace
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.extension:birthPlace.id
extension I 0..0 Extension Patient.extension:birthPlace.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.extension:birthPlace.url
http://hl7.org/fhir/StructureDefinition/patient-birthPlace
value[x] 1..1 Element id Patient.extension:birthPlace.value[x]
hasValue() or (children().count() > id.count())
valueAddress Address birthSex I 0..1 Extension(code) Element id Patient.extension:birthSex
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
cadavericDonor I 0..1 Extension(boolean) Element id Patient.extension:cadavericDonor
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.extension:cadavericDonor.id
extension I 0..0 Extension Patient.extension:cadavericDonor.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.extension:cadavericDonor.url
http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor
value[x] 1..1 Element id Patient.extension:cadavericDonor.value[x]
hasValue() or (children().count() > id.count())
valueBoolean boolean contactPreference I 0..1 Extension(Complex) Element id Patient.extension:contactPreference
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
deathNotificationStatus I 0..1 Extension(Complex) Element id Patient.extension:deathNotificationStatus
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
ethnicCategory I 0..1 Extension(CodeableConcept) Element id Patient.extension:ethnicCategory
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
residentialStatus I 0..1 Extension(CodeableConcept) Element id Patient.extension:residentialStatus
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
patientReligion I 0..1 Extension(CodeableConcept) Element id Patient.extension:patientReligion
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.extension:patientReligion.id
extension I 0..0 Extension Patient.extension:patientReligion.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.extension:patientReligion.url
http://hl7.org/fhir/StructureDefinition/patient-religion
value[x] 1..1 Binding Element id Patient.extension:patientReligion.value[x]
hasValue() or (children().count() > id.count())
valueCodeableConcept CodeableConcept patientInterpreterRequired I 0..1 Extension(boolean) Element id Patient.extension:patientInterpreterRequired
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.extension:patientInterpreterRequired.id
extension I 0..0 Extension Patient.extension:patientInterpreterRequired.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.extension:patientInterpreterRequired.url
http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
value[x] 1..1 Element id Patient.extension:patientInterpreterRequired.value[x]
hasValue() or (children().count() > id.count())
valueBoolean boolean modifierExtension ?! I 0..* Extension Patient.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Element id Patient.identifier
hasValue() or (children().count() > id.count())
nhsNumber Σ 0..1 Identifier Element id Patient.identifier:nhsNumber
hasValue() or (children().count() > id.count())
id 0..1 string Patient.identifier:nhsNumber.id
extension I 0..* Extension Element id Patient.identifier:nhsNumber.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
nhsNumberVerificationStatus I 0..1 Extension(CodeableConcept) Element id Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.identifier:nhsNumber.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.identifier:nhsNumber.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uriFixed Value Element id Patient.identifier:nhsNumber.system
hasValue() or (children().count() > id.count())
https://fhir.nhs.uk/Id/nhs-number
value Σ 1..1 string Patient.identifier:nhsNumber.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.identifier:nhsNumber.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.identifier:nhsNumber.assigner
hasValue() or (children().count() > id.count())
active Σ ?! 0..1 boolean Patient.active
hasValue() or (children().count() > id.count())
name Σ 0..* HumanName Patient.name
hasValue() or (children().count() > id.count())
telecom Σ 0..* ContactPoint Patient.telecom
hasValue() or (children().count() > id.count())
id 0..1 string Patient.telecom.id
extension I 0..* Extension Patient.telecom.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ I 0..1 codeBinding Patient.telecom.system
hasValue() or (children().count() > id.count())
id 0..1 string Patient.telecom.system.id
extension I 0..* Extension Element id Patient.telecom.system.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
otherContactSystem I 0..1 Extension(Coding) Element id Patient.telecom.system.extension:otherContactSystem
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
value 0..1 System.String Patient.telecom.system.value
value Σ 0..1 string Patient.telecom.value
hasValue() or (children().count() > id.count())
use Σ ?! 0..1 codeBinding Patient.telecom.use
hasValue() or (children().count() > id.count())
rank Σ 0..1 positiveInt Patient.telecom.rank
hasValue() or (children().count() > id.count())
period Σ 0..1 Period Patient.telecom.period
hasValue() or (children().count() > id.count())
gender Σ 0..1 codeBinding Patient.gender
hasValue() or (children().count() > id.count())
birthDate Σ 0..1 date Patient.birthDate
hasValue() or (children().count() > id.count())
id 0..1 string Patient.birthDate.id
extension I 0..* Extension Element id Patient.birthDate.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
birthTime I 0..1 Extension(dateTime) Element id Patient.birthDate.extension:birthTime
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.birthDate.extension:birthTime.id
extension I 0..0 Extension Patient.birthDate.extension:birthTime.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.birthDate.extension:birthTime.url
http://hl7.org/fhir/StructureDefinition/patient-birthTime
value[x] 1..1 Element id Patient.birthDate.extension:birthTime.value[x]
hasValue() or (children().count() > id.count())
valueDateTime dateTime value 0..1 System.Date Patient.birthDate.value
deceased[x] Σ ?! 0..1 Patient.deceased[x]
hasValue() or (children().count() > id.count())
deceasedBoolean boolean deceasedDateTime dateTime address Σ 0..* Address Element id Patient.address
hasValue() or (children().count() > id.count())
id 0..1 string Patient.address.id
extension I 0..* Extension Element id Patient.address.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
addressKey I 0..* Extension(Complex) Element id Patient.address.extension:addressKey
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.address.use
hasValue() or (children().count() > id.count())
home
Mappingstype Σ 0..1 codeBinding Patient.address.type
hasValue() or (children().count() > id.count())
both
Mappingstext Σ 0..1 string Patient.address.text
hasValue() or (children().count() > id.count())
137 Nowhere Street, Erewhon 9132
Mappingsline Σ 0..* string Patient.address.line
hasValue() or (children().count() > id.count())
137 Nowhere Street
Mappingscity Σ 0..1 string Patient.address.city
hasValue() or (children().count() > id.count())
Erewhon
Mappingsdistrict Σ 0..1 string Patient.address.district
hasValue() or (children().count() > id.count())
Madison
Mappingsstate Σ 0..1 string Patient.address.state
hasValue() or (children().count() > id.count())
postalCode Σ 0..1 string Patient.address.postalCode
hasValue() or (children().count() > id.count())
9132
Mappingscountry Σ 0..1 string Patient.address.country
hasValue() or (children().count() > id.count())
period Σ 0..1 Period Patient.address.period
hasValue() or (children().count() > id.count())
{
"start": "2010-03-23",
"end": "2010-07-01"
}
MappingsmaritalStatus 0..1 CodeableConceptBinding Element id Patient.maritalStatus
hasValue() or (children().count() > id.count())
multipleBirth[x] 0..1 Patient.multipleBirth[x]
hasValue() or (children().count() > id.count())
multipleBirthBoolean boolean multipleBirthInteger integer photo 0..* Attachment Patient.photo
hasValue() or (children().count() > id.count())
contact I 0..* BackboneElement Patient.contact
hasValue() or (children().count() > id.count())
name.exists() or telecom.exists() or address.exists() or organization.exists()
id 0..1 string Patient.contact.id
extension I 0..* Extension Element id Patient.contact.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
contactRank I 0..1 Extension(positiveInt) Element id Patient.contact.extension:contactRank
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
copyCorrespondenceIndicator I 0..1 Extension(boolean) Element id Patient.contact.extension:copyCorrespondenceIndicator
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Patient.contact.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
relationship 0..* CodeableConceptBinding Element id Patient.contact.relationship
hasValue() or (children().count() > id.count())
name 0..1 HumanName Patient.contact.name
hasValue() or (children().count() > id.count())
telecom 0..* ContactPoint Patient.contact.telecom
hasValue() or (children().count() > id.count())
id 0..1 string Patient.contact.telecom.id
extension I 0..* Extension Patient.contact.telecom.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ I 0..1 codeBinding Patient.contact.telecom.system
hasValue() or (children().count() > id.count())
id 0..1 string Patient.contact.telecom.system.id
extension I 0..* Extension Element id Patient.contact.telecom.system.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
otherContactSystem I 0..1 Extension(Coding) Element id Patient.contact.telecom.system.extension:otherContactSystem
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
value 0..1 System.String Patient.contact.telecom.system.value
value Σ 0..1 string Patient.contact.telecom.value
hasValue() or (children().count() > id.count())
use Σ ?! 0..1 codeBinding Patient.contact.telecom.use
hasValue() or (children().count() > id.count())
rank Σ 0..1 positiveInt Patient.contact.telecom.rank
hasValue() or (children().count() > id.count())
period Σ 0..1 Period Patient.contact.telecom.period
hasValue() or (children().count() > id.count())
address 0..1 Address Patient.contact.address
hasValue() or (children().count() > id.count())
gender 0..1 codeBinding Patient.contact.gender
hasValue() or (children().count() > id.count())
organization I 0..1 Reference() Element id Patient.contact.organization
hasValue() or (children().count() > id.count())
id 0..1 string Patient.contact.organization.id
extension I 0..* Extension Patient.contact.organization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Patient.contact.organization.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Patient.contact.organization.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Patient.contact.organization.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Patient.contact.organization.identifier.id
extension I 0..* Extension Patient.contact.organization.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.contact.organization.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.contact.organization.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Patient.contact.organization.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Patient.contact.organization.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.contact.organization.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.contact.organization.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Patient.contact.organization.display
hasValue() or (children().count() > id.count())
period 0..1 Period Patient.contact.period
hasValue() or (children().count() > id.count())
communication 0..* BackboneElement Patient.communication
hasValue() or (children().count() > id.count())
id 0..1 string Patient.communication.id
extension I 0..* Extension Element id Patient.communication.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
proficiency I 0..1 Extension(Complex) Element id Patient.communication.extension:proficiency
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.communication.extension:proficiency.id
extension I 0..* Extension Element id Patient.communication.extension:proficiency.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
level I 0..1 Extension Patient.communication.extension:proficiency.extension:level
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.communication.extension:proficiency.extension:level.id
extension I 0..0 Extension Patient.communication.extension:proficiency.extension:level.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.communication.extension:proficiency.extension:level.url
level
value[x] 1..1 Binding Element id Patient.communication.extension:proficiency.extension:level.value[x]
hasValue() or (children().count() > id.count())
valueCoding Coding type I 0..* Extension Patient.communication.extension:proficiency.extension:type
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.communication.extension:proficiency.extension:type.id
extension I 0..0 Extension Patient.communication.extension:proficiency.extension:type.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.communication.extension:proficiency.extension:type.url
type
value[x] 1..1 Binding Element id Patient.communication.extension:proficiency.extension:type.value[x]
hasValue() or (children().count() > id.count())
valueCoding Coding url 1..1 uriFixed Value Patient.communication.extension:proficiency.url
http://hl7.org/fhir/StructureDefinition/patient-proficiency
value[x] 0..0 Patient.communication.extension:proficiency.value[x]
hasValue() or (children().count() > id.count())
modifierExtension Σ ?! I 0..* Extension Patient.communication.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
language 1..1 CodeableConceptBinding Element id Patient.communication.language
hasValue() or (children().count() > id.count())
preferred 0..1 boolean Patient.communication.preferred
hasValue() or (children().count() > id.count())
generalPractitioner 0..* Reference( | | ) Element id Patient.generalPractitioner
hasValue() or (children().count() > id.count())
id 0..1 string Patient.generalPractitioner.id
extension I 0..* Extension Patient.generalPractitioner.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Patient.generalPractitioner.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Patient.generalPractitioner.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Patient.generalPractitioner.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Patient.generalPractitioner.identifier.id
extension I 0..* Extension Patient.generalPractitioner.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.generalPractitioner.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.generalPractitioner.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Patient.generalPractitioner.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Patient.generalPractitioner.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.generalPractitioner.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.generalPractitioner.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Patient.generalPractitioner.display
hasValue() or (children().count() > id.count())
managingOrganization Σ 0..1 Reference() Element id Patient.managingOrganization
hasValue() or (children().count() > id.count())
id 0..1 string Patient.managingOrganization.id
extension I 0..* Extension Patient.managingOrganization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Patient.managingOrganization.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Patient.managingOrganization.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Patient.managingOrganization.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Patient.managingOrganization.identifier.id
extension I 0..* Extension Patient.managingOrganization.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.managingOrganization.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.managingOrganization.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Patient.managingOrganization.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Patient.managingOrganization.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.managingOrganization.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.managingOrganization.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Patient.managingOrganization.display
hasValue() or (children().count() > id.count())
link Σ ?! 0..* BackboneElement Patient.link
hasValue() or (children().count() > id.count())
id 0..1 string Patient.link.id
extension I 0..* Extension Patient.link.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Patient.link.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
other Σ 1..1 Reference( | ) Element id Patient.link.other
hasValue() or (children().count() > id.count())
id 0..1 string Patient.link.other.id
extension I 0..* Extension Patient.link.other.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Patient.link.other.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Patient.link.other.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Patient.link.other.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Patient.link.other.identifier.id
extension I 0..* Extension Patient.link.other.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.link.other.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.link.other.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Patient.link.other.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Patient.link.other.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.link.other.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.link.other.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Patient.link.other.display
hasValue() or (children().count() > id.count())
type Σ 1..1 codeBinding Patient.link.type
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
Patient
https://simplifier.net/hl7fhirukcorer4/ukcore-patient
1..1
Patient.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
9589fb37-87a2-48d8-968f-b371429208a8
Patient.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Patient.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient
Patient.meta.LastUpdate
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Patient.identifier
SHOULD
0..*
Patient.identifier.system
This SHOULD be populated with namespace for the Identifier
SHOULD
1..1
https://fhir.nhs.uk/Id/nhs-number
Patient.identifier.value
This SHOULD be populated with a human readable patient identifier. When used this MUST be populated with the NHS number when available.If no NHS number is available this SHOULD be populated with the Local patient identifier.
SHOULD
1..1
3478526985
Patient.identifier.extension
This extension is used to record the NHS number Verification status
SHOULD
0..*
Patient.identifier.extension.url
This SHOULD be populated. Where used this MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus' - FIXED VALUE
SHOULD
1..1
https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus
Patient.identifier.extension.valueCodeableConcept
SHOULD
0..1
Patient.identifier.extension.valueCodeableConcept.coding
SHOULD
0..1
Patient.identifier.extension.valueCodeableConcept.coding.system
This SHOULD be populated. Where used this MUST be populated with CodeSystem - 'https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus' - FIXED VALUE
SHOULD
0..1
https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus
Patient.identifier.extension.valueCodeableConcept.coding.code
This SHOULD be populated. Where used this MUST either be number-present-and-verified or no NHS number MUST be sent, no other status is valid
SHOULD
0..1
number-present-and-verified
Patient.identifier.extension.valueCodeableConcept.coding.display
This SHOULD be populated. Where used this MUST either be populated with 'Number present and-verified' no other status is valid
SHOULD
0..1
Number present and verified
Patient.name
SHOULD
0..*
Patient.name.use
Follow UK Core guidance for populating this element
SHOULD
0..1
official
Patient.name.text
Follow UK Core guidance for populating this element
SHOULD
0..1
Mrs Julie Jones
Patient.name.family
Follow UK Core guidance for populating this element
SHOULD
0..1
Jones
Patient.name.given
Follow UK Core guidance for populating this element
SHOULD
0..1
Julie
Patient.name.prefix
Follow UK Core guidance for populating this element
SHOULD
0..1
Mrs
Patient.gender
Follow UK Core guidance for populating this element
SHOULD
0..1
female
Patient.birthDate
Follow UK Core guidance for populating this element
SHOULD
0..1
1959-05-04
Patient.address
SHOULD
0..*
Patient.address.use
This SHOULD be populated. Where used 'home' MUST only be used for the patient's official residing address. 'temp' is used for alternative current locations with an address format, otherwise, a Location resource can be used to pinpoint a location without a building address
SHOULD
0..1
home
Patient.address.type
Follow UK Core guidance for populating this element
SHOULD
0..1
both
Patient.address.text
Follow UK Core guidance for populating this element
SHOULD
0..1
22 Brightside Crescent, Overtown, West Yorkshire, LS10 4YU
Patient.address.line
Follow UK Core guidance for populating this element
SHOULD
0..*
22 Brightside Crescent
Patient.address.city
Follow UK Core guidance for populating this element
SHOULD
0..1
Overtown
Patient.address.district
Follow UK Core guidance for populating this element
SHOULD
0..1
West Yorkshire
Patient.address.postalCode
Follow UK Core guidance for populating this element
SHOULD
0..1
LS10 4YU
Patient.contact
This MUST be used to record telecom information for the patient and/or the patient's representative for the encounter
MUST
0..*
Patient.contact.extension
MUST
0..*
Patient.contact.extension.url
This MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank' - FIXED VALUE
MUST
0..1
https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank
Patient.contact.extension.urlvaluePositiveInt
This MUST be populated with the rank of the whole contact and MUST be populated with the value '1' for the primary person to contact for referral. There MUST be at least one contact for the referral.
MUST
0..1
1
Patient.contact.relationship
MUST
0..*
Patient.contact.relationship.coding
MUST
Patient.contact.relationship.coding.system
This MUST be populated with the CodeSystem from the ValueSet 'https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-personrelationshiptype'.
Where the contact details relate to the patient this relationship MUST be populated with the value 'self'.
Where the contact details relate to a patient's representative this SHOULD be populated with their relationship to the patient.
If the relationship is not known this SHOULD be populated with the value 'Unknown'MUST
0..1
http://terminology.hl7.org/CodeSystem/v2-0131
Patient.contact.relationship.coding.code
This MUST be populated with Code of CodeSystem value. See ValueSet 'https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-personrelationshiptype'.
MUST
0..1
EP
Patient.contact.relationship.coding.display
This MUST be populated with Display of CodeSystem value. See ValueSet 'https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-personrelationshiptype'.
MUST
0..1
EP
Patient.contact.name
SHOULD
0..1
Patient.contact.name.family
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
Grayson
Patient.contact.name.given
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
Jack
Patient.contact.telecom
MUST
0..*
Patient.contact.telecom.system
This MUST be populated for the rank 1 contact. There MUST be at least one contact phone number for the referral
MUST
0..1
phone
Patient.contact.telecom.value
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
0789 1234567
Patient.contact.gender
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
male
Patient.Communication
SHOULD
0..*
Patient.Communication.Language
SHOULD
1..1
Patient.Communication.Language.coding
SHOULD
1..1
Patient.Communication.Language.coding.code
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
en
Patient.Communication.Language.coding.system
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
https://fhir.hl7.org.uk/CodeSystem/UKCore-HumanLanguage
Patient.Communication.Language.coding.display
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
English
Patient.Communication.Language.preferred
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
TRUE
Patient.extension
SHOULD
0..1
Patient.extension
SHOULD
0..*
Patient.extension.url
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
1..1
https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory
Patient.extension.valueCodeableConcept
SHOULD
0..1
Patient.extension.valueCodeableConcept.coding
SHOULD
0..*
Patient.extension.valueCodeableConcept.coding.system
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
https://fhir.hl7.org.uk/CodeSystem/UKCore-EthnicCategory
Patient.extension.valueCodeableConcept.coding.code
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
A
Patient.extension.valueCodeableConcept.coding.display
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
British, Mixed British
Patient.generalPractitioner
This SHOULD be populated with a reference to the GP Surgery ONLY rather than a specific practitioner
SHOULD
0..*
Patient.generalPractitioner.reference
This SHOULD be populated. Where populated this MUST reference to an Organisation resource
SHOULD
1..1
urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4411
This resource is used to communicate details about the sender and receiver organisations. A grouping of people or organizations with a common purpose A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Main location extensions, user content The main location of the organisation. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MainLocation The date range that this organization should be considered available. extensions, user content The date range that this organization should be considered available. 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. http://hl7.org/fhir/StructureDefinition/organization-period Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The date range that this organization should be considered available. The date range that this organization should be considered available. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Identifies this organization across multiple systems Identifier for the organization that is used to identify the organization across multiple disparate systems. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Unordered, Open, by system(Value) Organisation Data Service code Identifier code supplier by the Organisation Data Service. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. ODS Site code to identify the organisation at site level ODS Site code to identify the organisation at site level. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether the organization's record is still in active use Whether the organization's record is still in active use. Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI. This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used. This element is labeled as a modifier because it may be used to mark that the resource was created in error. This resource is generally assumed to be active if no value is provided for the active element Kind of organization The kind(s) of organization that this is. Need to be able to track the kind of organization that this is - different organization types have different uses. Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center. We expect that some jurisdictions will profile this optionality to be a single cardinality. Used to categorize the organization. Name used for the organization A name associated with the organization. Need to use the name as the label of the organization. If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches. A list of alternate names that the organization is known as, or was known as in the past A list of alternate names that the organization is known as, or was known as in the past. Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the organization was known by can be very useful. There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization. A contact detail for the organization A contact detail for the organization. Human contact for the organization. The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself. An address for the organization An address for the organization. May need to keep track of the organization's addresses for contacting, billing or reporting requirements. Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used. The organization of which this organization forms a part The organization of which this organization forms a part. Need to be able to track the hierarchy of organizations within an organization. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Contact for the organization for a certain purpose Contact for the organization for a certain purpose. Need to keep track of assigned contact points within bigger organization. Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The type of contact Indicates a purpose for which the contact can be reached. Need to distinguish between multiple contact persons. The purpose for which you would contact a contact party. A name associated with the contact A name associated with the contact. Need to be able to track the person by name. Contact details (telephone, email, etc.) for a contact A contact detail (e.g. a telephone number or an email address) by which the party may be contacted. People have (primary) ways to contact them in some way such as phone, email. Visiting or postal addresses for the contact Visiting or postal addresses for the contact. May need to keep track of a contact party's address for contacting, billing or reporting requirements. Technical endpoints providing access to services operated for the organization Technical endpoints providing access to services operated for the organization. Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
> Organization
UKCoreOrganization (Organization) I Organization Organization
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
(identifier.count() + name.count()) > 0
id Σ 0..1 string Organization.id
meta Σ 0..1 Meta Organization.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Organization.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Organization.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Organization.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Organization.contained
extension I 0..* Extension Element id Organization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
mainLocation I 0..* Extension(Reference()) Element id Organization.extension:mainLocation
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
organizationPeriod I 0..1 Extension(Period) Element id Organization.extension:organizationPeriod
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Organization.extension:organizationPeriod.id
extension I 0..0 Extension Organization.extension:organizationPeriod.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Organization.extension:organizationPeriod.url
http://hl7.org/fhir/StructureDefinition/organization-period
value[x] 1..1 Element id Organization.extension:organizationPeriod.value[x]
hasValue() or (children().count() > id.count())
valuePeriod Period modifierExtension ?! I 0..* Extension Organization.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ I 0..* Identifier Element id Organization.identifier
hasValue() or (children().count() > id.count())
odsOrganisationCode Σ I 0..1 Identifier Element id Organization.identifier:odsOrganisationCode
hasValue() or (children().count() > id.count())
id 0..1 string Organization.identifier:odsOrganisationCode.id
extension I 0..* Extension Organization.identifier:odsOrganisationCode.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Organization.identifier:odsOrganisationCode.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Organization.identifier:odsOrganisationCode.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uriFixed Value Element id Organization.identifier:odsOrganisationCode.system
hasValue() or (children().count() > id.count())
https://fhir.nhs.uk/Id/ods-organization-code
value Σ 1..1 string Organization.identifier:odsOrganisationCode.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Organization.identifier:odsOrganisationCode.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Organization.identifier:odsOrganisationCode.assigner
hasValue() or (children().count() > id.count())
odsSiteCode Σ I 0..1 Identifier Element id Organization.identifier:odsSiteCode
hasValue() or (children().count() > id.count())
id 0..1 string Organization.identifier:odsSiteCode.id
extension I 0..* Extension Organization.identifier:odsSiteCode.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Organization.identifier:odsSiteCode.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Organization.identifier:odsSiteCode.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uriFixed Value Element id Organization.identifier:odsSiteCode.system
hasValue() or (children().count() > id.count())
https://fhir.nhs.uk/Id/ods-site-code
value Σ 1..1 string Organization.identifier:odsSiteCode.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Organization.identifier:odsSiteCode.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Organization.identifier:odsSiteCode.assigner
hasValue() or (children().count() > id.count())
active Σ ?! 0..1 boolean Organization.active
hasValue() or (children().count() > id.count())
type Σ 0..* CodeableConcept Organization.type
hasValue() or (children().count() > id.count())
name Σ I 0..1 string Organization.name
hasValue() or (children().count() > id.count())
alias 0..* string Organization.alias
hasValue() or (children().count() > id.count())
telecom I 0..* ContactPoint Organization.telecom
hasValue() or (children().count() > id.count())
where(use = 'home').empty()
address I 0..* Address Organization.address
hasValue() or (children().count() > id.count())
where(use = 'home').empty()
partOf Σ 0..1 Reference() Element id Organization.partOf
hasValue() or (children().count() > id.count())
id 0..1 string Organization.partOf.id
extension I 0..* Extension Organization.partOf.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Organization.partOf.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Organization.partOf.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Organization.partOf.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Organization.partOf.identifier.id
extension I 0..* Extension Organization.partOf.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Organization.partOf.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Organization.partOf.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Organization.partOf.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Organization.partOf.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Organization.partOf.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Organization.partOf.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Organization.partOf.display
hasValue() or (children().count() > id.count())
contact 0..* BackboneElement Organization.contact
hasValue() or (children().count() > id.count())
id 0..1 string Organization.contact.id
extension I 0..* Extension Organization.contact.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Organization.contact.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
purpose 0..1 CodeableConceptBinding Organization.contact.purpose
hasValue() or (children().count() > id.count())
name 0..1 HumanName Organization.contact.name
hasValue() or (children().count() > id.count())
telecom 0..* ContactPoint Organization.contact.telecom
hasValue() or (children().count() > id.count())
address 0..1 Address Organization.contact.address
hasValue() or (children().count() > id.count())
endpoint 0..* Reference(Endpoint) Organization.endpoint
hasValue() or (children().count() > id.count())
id 0..1 string Organization.endpoint.id
extension I 0..* Extension Organization.endpoint.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Organization.endpoint.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Organization.endpoint.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Organization.endpoint.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Organization.endpoint.identifier.id
extension I 0..* Extension Organization.endpoint.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Organization.endpoint.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Organization.endpoint.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Organization.endpoint.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Organization.endpoint.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Organization.endpoint.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Organization.endpoint.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Organization.endpoint.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
Organization
https://simplifier.net/hl7fhirukcorer4/ukcore-organization
2..*
Organization.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
5d897313-c62d-4e7e-92b7-b2199804fed3
Organization.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Organization.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
Organization.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Organization.identifier
This MUST be populated with an organisation identifier e.g. ODS code
MUST
0..*
Organization.identifier.system
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
https://fhir.nhs.uk/id/ods-organization-code
Organization.identifier.value
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
ABD01
Organization.name
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
Organisation name
This is used to carry details of the healthcare professional making the referral A person with a formal responsibility in the provisioning of healthcare or related services A person who is directly or indirectly involved in the provisioning of healthcare. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. An identifier for the person as this agent An identifier that applies to this person in this role. Often, specific identities are assigned for the agent. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this practitioner's record is in active use Whether this practitioner's record is in active use. Need to be able to mark a practitioner record as not to be used because it was created in error. If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role. This resource is generally assumed to be active if no value is provided for the active element The name(s) associated with the practitioner The name(s) associated with the practitioner. The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display. The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate. In general, select the value to be used in the ResourceReference.display based on this: A contact detail for the practitioner (that apply to all roles) A contact detail for the practitioner, e.g. a telephone number or an email address. Need to know how to reach a practitioner independent to any roles the practitioner may have. Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific. Address(es) of the practitioner that are not role specific (typically home address) 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. The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations. The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address). male | female | other | unknown Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes. Needed to address the person correctly. The gender of a person used for administrative purposes. The date on which the practitioner was born The date of birth for the practitioner. Needed for identification. Image of the person Image of the person. Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too. Certification, licenses, or training pertaining to the provision of care 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. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. An identifier for this qualification for the practitioner An identifier that applies to this person's qualification in this role. Often, specific identities are assigned for the qualification. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Coded representation of the qualification Coded representation of the qualification. Specific qualification the practitioner has to provide a service. Period during which the qualification is valid Period during which the qualification is valid. Qualifications are often for a limited period of time, and can be revoked. Organization that regulates and issues the qualification Organization that regulates and issues the qualification. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. A language the practitioner can use in patient communication A language the practitioner can use in patient communication. Knowing which language a practitioner speaks can help in facilitating communication with patients. 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. A human language.
> Practitioner
UKCorePractitioner (Practitioner) I Practitioner Practitioner
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Practitioner.id
meta Σ 0..1 Meta Practitioner.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Practitioner.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Practitioner.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Practitioner.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Practitioner.contained
extension I 0..* Extension Practitioner.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Practitioner.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Practitioner.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.identifier.id
extension I 0..* Extension Practitioner.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Practitioner.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Practitioner.identifier.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uri Practitioner.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 1..1 string Practitioner.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Practitioner.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Practitioner.identifier.assigner
hasValue() or (children().count() > id.count())
active Σ 0..1 boolean Practitioner.active
hasValue() or (children().count() > id.count())
name Σ 0..* HumanName Practitioner.name
hasValue() or (children().count() > id.count())
telecom Σ 0..* ContactPoint Practitioner.telecom
hasValue() or (children().count() > id.count())
address Σ 0..* Address Practitioner.address
hasValue() or (children().count() > id.count())
gender Σ 0..1 codeBinding Practitioner.gender
hasValue() or (children().count() > id.count())
birthDate Σ 0..1 date Practitioner.birthDate
hasValue() or (children().count() > id.count())
photo 0..* Attachment Practitioner.photo
hasValue() or (children().count() > id.count())
qualification 0..* BackboneElement Practitioner.qualification
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.qualification.id
extension I 0..* Extension Practitioner.qualification.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Practitioner.qualification.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier 0..* Identifier Practitioner.qualification.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.qualification.identifier.id
extension I 0..* Extension Practitioner.qualification.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Practitioner.qualification.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Practitioner.qualification.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Practitioner.qualification.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Practitioner.qualification.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Practitioner.qualification.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Practitioner.qualification.identifier.assigner
hasValue() or (children().count() > id.count())
code 1..1 CodeableConcept Practitioner.qualification.code
hasValue() or (children().count() > id.count())
period 0..1 Period Practitioner.qualification.period
hasValue() or (children().count() > id.count())
issuer 0..1 Reference() Element id Practitioner.qualification.issuer
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.qualification.issuer.id
extension I 0..* Extension Practitioner.qualification.issuer.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Practitioner.qualification.issuer.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Practitioner.qualification.issuer.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Practitioner.qualification.issuer.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.qualification.issuer.identifier.id
extension I 0..* Extension Practitioner.qualification.issuer.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Practitioner.qualification.issuer.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Practitioner.qualification.issuer.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Practitioner.qualification.issuer.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Practitioner.qualification.issuer.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Practitioner.qualification.issuer.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Practitioner.qualification.issuer.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Practitioner.qualification.issuer.display
hasValue() or (children().count() > id.count())
communication 0..* CodeableConceptBinding Practitioner.communication
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
Practitioner
https://simplifier.net/hl7fhirukcorer4/ukcore-practitioner
1..*
Practitioner.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
51182cb1-b199-4222-85f5-16d5428f6358
Practitioner.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Practitioner.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner
Practitioner.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Practitioner.identifier
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..*
Practitioner.identifier.system
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
https://fhir.nhs.uk/Id/sds-role-profile-id
Practitioner.identifier.value
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
PT2489
Practitioner.name
SHOULD
0..*
Practitioner.name.family
Follow UK Core guidance for populating this element
SHOULD
0..1
BLAKE
Practitioner.name.given
Follow UK Core guidance for populating this element
SHOULD
0..1
Marcy
Practitioner.telecom
SHOULD
0..*
Practitioner.telecom.system
Follow UK Core guidance for populating this element
SHOULD
0..1
phone
Practitioner.telecom.value
Follow UK Core guidance for populating this element
SHOULD
0..1
0205568263
Practitioner.telecom.use
Follow UK Core guidance for populating this element
SHOULD
0..1
work
This is used to carry the role of the practitioner making the referral. Note this may be the call handler Roles/organizations the practitioner is associated with A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. An identifier that applies to this person in this role. An identifier that applies to this person in this role. Often, specific identities are assigned for the agent. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this practitioner role record is in active use Whether this practitioner role record is in active use. 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. 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. This resource is generally assumed to be active if no value is provided for the active element The period during which the practitioner is authorized to perform in these role(s) The period during which the person is authorized to act as a practitioner in these role(s) for the organization. Even after the agencies is revoked, the fact that it existed must still be recorded. Practitioner that is able to provide the defined services for the organization Practitioner that is able to provide the defined services for the organization. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Organization where the roles are available The organization where the Practitioner performs the roles associated. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Roles which this practitioner may perform Roles which this practitioner is authorized to perform for the organization. Need to know what authority the practitioner has - what can they do? A person may have more than one role. The role a person plays representing an organization. Specific specialty of the practitioner Specific specialty of the practitioner. Specific specialty associated with the agency. The location(s) at which this practitioner provides care The location(s) at which this practitioner provides care. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The list of healthcare services that this worker provides for this role's Organization/Location(s) The list of healthcare services that this worker provides for this role's Organization/Location(s). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Contact details that are specific to the role/location/service Contact details that are specific to the role/location/service. 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. Times the Service Site is available A collection of times the practitioner is available or performing this role at the location and/or healthcareservice. More detailed availability information may be provided in associated Schedule/Slot resources. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. mon | tue | wed | thu | fri | sat | sun Indicates which days of the week are available between the start and end Times. The days of the week. Always available? e.g. 24 hour service Is this always available? (hence times are irrelevant) e.g. 24 hour service. Opening time of day (ignored if allDay = true) The opening time of day. Note: If the AllDay flag is set, then this time is ignored. The timezone is expected to be for where this HealthcareService is provided at. Closing time of day (ignored if allDay = true) The closing time of day. Note: If the AllDay flag is set, then this time is ignored. The timezone is expected to be for where this HealthcareService is provided at. Not available during this time due to provided reason The practitioner is not available or performing this role during this period of time due to the provided reason. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Reason presented to the user explaining why time not available The reason that can be presented to the user as to why this time is not available. Service not available from this date Service is not available (seasonally or for a public holiday) from this date. Description of availability exceptions 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. Technical endpoints providing access to services operated for the practitioner with this role Technical endpoints providing access to services operated for the practitioner with this role. 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. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
> Practitioner Role
UKCorePractitionerRole (PractitionerRole) I PractitionerRole PractitionerRole
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string PractitionerRole.id
meta Σ 0..1 Meta PractitionerRole.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri PractitionerRole.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding PractitionerRole.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative PractitionerRole.text
hasValue() or (children().count() > id.count())
contained 0..* Resource PractitionerRole.contained
extension I 0..* Extension PractitionerRole.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension PractitionerRole.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Element id PractitionerRole.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.identifier.id
extension I 0..* Extension PractitionerRole.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.identifier.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uri PractitionerRole.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 1..1 string PractitionerRole.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.identifier.assigner
hasValue() or (children().count() > id.count())
active Σ 0..1 boolean PractitionerRole.active
hasValue() or (children().count() > id.count())
period Σ 0..1 Period PractitionerRole.period
hasValue() or (children().count() > id.count())
practitioner Σ 0..1 Reference() Element id PractitionerRole.practitioner
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.practitioner.id
extension I 0..* Extension PractitionerRole.practitioner.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.practitioner.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.practitioner.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.practitioner.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.practitioner.identifier.id
extension I 0..* Extension PractitionerRole.practitioner.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.practitioner.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.practitioner.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.practitioner.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.practitioner.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.practitioner.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.practitioner.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.practitioner.display
hasValue() or (children().count() > id.count())
organization Σ 0..1 Reference() Element id PractitionerRole.organization
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.organization.id
extension I 0..* Extension PractitionerRole.organization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.organization.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.organization.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.organization.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.organization.identifier.id
extension I 0..* Extension PractitionerRole.organization.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.organization.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.organization.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.organization.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.organization.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.organization.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.organization.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.organization.display
hasValue() or (children().count() > id.count())
code Σ 0..* CodeableConceptBinding Element id PractitionerRole.code
hasValue() or (children().count() > id.count())
specialty Σ 0..* CodeableConceptBinding PractitionerRole.specialty
hasValue() or (children().count() > id.count())
location Σ 0..* Reference() Element id PractitionerRole.location
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.location.id
extension I 0..* Extension PractitionerRole.location.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.location.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.location.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.location.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.location.identifier.id
extension I 0..* Extension PractitionerRole.location.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.location.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.location.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.location.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.location.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.location.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.location.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.location.display
hasValue() or (children().count() > id.count())
healthcareService 0..* Reference(HealthcareService) PractitionerRole.healthcareService
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.healthcareService.id
extension I 0..* Extension PractitionerRole.healthcareService.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.healthcareService.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.healthcareService.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.healthcareService.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.healthcareService.identifier.id
extension I 0..* Extension PractitionerRole.healthcareService.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.healthcareService.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.healthcareService.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.healthcareService.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.healthcareService.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.healthcareService.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.healthcareService.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.healthcareService.display
hasValue() or (children().count() > id.count())
telecom Σ 0..* ContactPoint PractitionerRole.telecom
hasValue() or (children().count() > id.count())
availableTime 0..* BackboneElement PractitionerRole.availableTime
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.availableTime.id
extension I 0..* Extension PractitionerRole.availableTime.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension PractitionerRole.availableTime.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
daysOfWeek 0..* codeBinding PractitionerRole.availableTime.daysOfWeek
hasValue() or (children().count() > id.count())
allDay 0..1 boolean PractitionerRole.availableTime.allDay
hasValue() or (children().count() > id.count())
availableStartTime 0..1 time PractitionerRole.availableTime.availableStartTime
hasValue() or (children().count() > id.count())
availableEndTime 0..1 time PractitionerRole.availableTime.availableEndTime
hasValue() or (children().count() > id.count())
notAvailable 0..* BackboneElement PractitionerRole.notAvailable
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.notAvailable.id
extension I 0..* Extension PractitionerRole.notAvailable.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension PractitionerRole.notAvailable.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
description 1..1 string PractitionerRole.notAvailable.description
hasValue() or (children().count() > id.count())
during 0..1 Period PractitionerRole.notAvailable.during
hasValue() or (children().count() > id.count())
availabilityExceptions 0..1 string PractitionerRole.availabilityExceptions
hasValue() or (children().count() > id.count())
endpoint 0..* Reference(Endpoint) PractitionerRole.endpoint
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.endpoint.id
extension I 0..* Extension PractitionerRole.endpoint.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.endpoint.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.endpoint.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.endpoint.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.endpoint.identifier.id
extension I 0..* Extension PractitionerRole.endpoint.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.endpoint.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.endpoint.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.endpoint.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.endpoint.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.endpoint.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.endpoint.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.endpoint.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
PractitionerRole
https://simplifier.net/hl7fhirukcorer4/ukcore-practitionerrole
1..*
PractitionerRole.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
1801e180-e6a1-4753-8a55-ab2d1cff6549
PractitionerRole.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
PractitionerRole.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole
PractitionerRole.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
PractitionerRole.practitioner
MUST
0..1
PractitionerRole.practitioner.reference
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
PractitionerRole.Organisation
MUST
0..1
PractitionerRole.Organisation.reference
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb51
PractitionerRole.code
SHOULD
0..*
PractitionerRole.code.coding
This SHOULD be populated when indicating the roles a practitioner can perform
SHOULD
1..1
PractitionerRole.code.coding.system
This MUST be populated with the CodeSystem from the ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode' - FIXED VALUE
SHOULD
0..1
https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode
PractitionerRole.code.coding.code
This MUST be populated with Code of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'.
SHOULD
0..1
224508005
PractitionerRole.code.coding.display
This MUST be populated with Display of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'.
SHOULD
0..1
Administrative healthcare staff
This resource MAY be used to carry new medication prescribed at the encounter. This SHOULD NOT be used to carry Medication History obtained from external sources. Record of medication being taken by a patient A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information. When interpreting a medicationStatement, the value of the status and NotTaken needed to be considered:
MedicationStatement.status + MedicationStatement.wasNotTaken
Status=Active + NotTaken=T = Not currently taking
Status=Completed + NotTaken=T = Not taken in the past
Status=Intended + NotTaken=T = No intention of taking
Status=Active + NotTaken=F = Taking, but not as prescribed
Status=Active + NotTaken=F = Taking
Status=Intended +NotTaken= F = Will be taking (not started)
Status=Completed + NotTaken=F = Taken in past
Status=In Error + NotTaken=N/A = In Error. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Indicates whether a pharmacist verified a medication extensions, user content This extension is used to indicate whether a pharmacist verified a medication. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-PharmacistVerifiedIndicator The type of organisation or setting responsible for authorising and issuing a medication extensions, user content This extension carries the type of organisation or setting responsible for authorising and issuing a medication. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationPrescribingOrganization The date when a prescription was last issued extensions, user content This extension supports the exchange of the date information when a prescription was last issued. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MedicationStatementLastIssueDate Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. External identifier Identifiers associated with this Medication Statement that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate. They are business identifiers assigned to this resource by the performer or other systems and remain constant as the resource is updated and propagates from server to server. This is a business identifier, not a resource identifier. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Fulfils plan, proposal or order A plan, proposal or order that is fulfilled in whole or in part by this event. Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Part of referenced event A larger event of which this particular event is a component or step. This should not be used when indicating which resource a MedicationStatement has been derived from. If that is the use case, then MedicationStatement.derivedFrom should be used. Reference( | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. active | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken A code representing the patient or other source's judgment about the state of the medication used that this statement is about. Generally, this will be active or completed. MedicationStatement is a statement at a point in time. The status is only representative at the point when it was asserted. The value set for MedicationStatement.status contains codes that assert the status of the use of the medication by the patient (for example, stopped or on hold) as well as codes that assert the status of the medication statement itself (for example, entered in error). This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A coded concept indicating the current status of a MedicationStatement. Reason for current status Captures the reason for the current state of the MedicationStatement. This is generally only used for "exception" statuses such as "not-taken", "on-hold", "cancelled" or "entered-in-error". The reason for performing the event at all is captured in reasonCode, not here. A coded concept indicating the reason for the status of the statement. Type of medication usage Indicates where the medication is expected to be consumed or administered. A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered. What medication was taken Identifies the medication being administered. This is either a link to a resource representing the details of the medication or a simple attribute carrying a code that identifies the medication from a known list of medications. If only a code is specified, then it needs to be a code for a specific product. If more information is required, then the use of the medication resource is recommended. For example, if you require form or lot number, then you must reference the Medication resource. A coded concept identifying the substance or product being taken. Who is/was taking the medication The person, animal or group who is/was taking the medication. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Encounter / Episode associated with MedicationStatement The encounter or episode of care that establishes the context for this MedicationStatement. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The date/time or interval when the medication is/was/will be taken The interval of time during which it is being asserted that the patient is/was/will be taking the medication (or was not taking, when the MedicationStatement.taken element is No). This attribute reflects the period over which the patient consumed the medication and is expected to be populated on the majority of Medication Statements. If the medication is still being taken at the time the statement is recorded, the "end" date will be omitted. The date/time attribute supports a variety of dates - year, year/month and exact date. If something more than this is required, this should be conveyed as text. When the statement was asserted? The date when the medication statement was asserted by the information source. Person or organization that provided the information about the taking of this medication The person or organization that provided the information about the taking of this medication. Note: Use derivedFrom when a MedicationStatement is derived from other resources, e.g. Claim or MedicationRequest. Reference( | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Additional supporting information Allows linking the MedicationStatement to the underlying MedicationRequest, or to other information that supports or is used to derive the MedicationStatement. Likely references would be to MedicationRequest, MedicationDispense, Claim, Observation or QuestionnaireAnswers. The most common use cases for deriving a MedicationStatement comes from creating a MedicationStatement from a MedicationRequest or from a lab observation or a claim. it should be noted that the amount of information that is available varies from the type resource that you derive the MedicationStatement from. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Reason for why the medication is being/was taken A reason for why the medication is being/was taken. This could be a diagnosis code. If a full condition record exists or additional detail is needed, use reasonForUseReference. A coded concept identifying why the medication is being taken. Condition or observation that supports why the medication is being/was taken Condition or observation that supports why the medication is being/was taken. This is a reference to a condition that is the reason why the medication is being/was taken. If only a code exists, use reasonForUseCode. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Further information about the statement Provides extra information about the medication statement that is not conveyed by the other attributes. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Individual responsible for the annotation The individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment. Reference( | | ) When the annotation was made Indicates when this particular annotation was made. The annotation - text content (as markdown) The text of the annotation in markdown format. Details of how medication is/was taken or should be taken Indicates how the medication is/was or should be taken by the patient. The dates included in the dosage on a Medication Statement reflect the dates for a given dose. For example, "from November 1, 2016 to November 3, 2016, take one tablet daily and from November 4, 2016 to November 7, 2016, take two tablets daily." It is expected that this specificity may only be populated where the patient brings in their labeled container or where the Medication Statement is derived from a MedicationRequest. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The order of the dosage instructions Indicates the order in which the dosage instructions should be applied or interpreted. If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. Free text dosage instructions e.g. SIG Free text dosage instructions e.g. SIG. Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). Additional instruction is intended to be coded, but where no code exists, the element could include text. For example, "Swallow with plenty of water" which might or might not be coded. Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or "immediately following drug x") should be populated in dosage.text. A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery". Patient or consumer oriented instructions Instructions in terms that are understood by the patient or consumer. When medication should be administered When medication should be administered. The timing schedule for giving the medication to the patient. This data type allows many different expressions. For example: "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013". Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. This attribute might not always be populated while the Dosage.text is expected to be populated. If both are populated, then the Dosage.text should reflect the content of the Dosage.timing. Take "as needed" (for x) Indicates whether the Medication is only taken when needed within a specific dosing schedule (Boolean option), or it indicates the precondition for taking the Medication (CodeableConcept). Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. Or you can express "as needed" with a reason by including the CodeableConcept. In this case the Boolean is assumed to be True. If you set the Boolean to False, then the dose is given according to the schedule and is not "prn" or "as needed". A set of codes that define a precondition for taking a medication Body site to administer to Body site to administer to. A coded specification of the anatomic site where the medication first enters the body. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both. A coded concept describing the site location the medicine enters into or onto the body. How drug should enter body How drug should enter body. A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. Technique for administering medication Technique for administering medication. A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. Terminologies used often pre-coordinate this term with the route and or form of administration. A coded concept describing the technique by which the medicine is administered. Amount of medication administered The amount of medication administered. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) The kind of dose or rate specified The kind of dose or rate specified, for example, ordered or calculated. If the type is not populated, assume to be "ordered". The kind of dose or rate specified. Amount of medication per dose Amount of medication per dose. The amount of therapeutic or other substance given at one administration event. Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. Amount of medication per unit of time Amount of medication per unit of time. Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammer where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. Upper limit on medication per unit of time Upper limit on medication per unit of time. The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. This is intended for use as an adjunct to the dosage when there is an upper cap. For example "2 tablets every 4 hours to a maximum of 8/day". Upper limit on medication per administration Upper limit on medication per administration. The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. Upper limit on medication per lifetime of the patient Upper limit on medication per lifetime of the patient. The maximum total quantity of a therapeutic substance that may be administered per lifetime of the subject.
> Medication Statement
UKCoreMedicationStatement (MedicationStatement) I MedicationStatement MedicationStatement
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string MedicationStatement.id
meta Σ 0..1 Meta MedicationStatement.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri MedicationStatement.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding MedicationStatement.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative MedicationStatement.text
hasValue() or (children().count() > id.count())
contained 0..* Resource MedicationStatement.contained
extension I 0..* Extension Element id MedicationStatement.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
pharmacistVerifiedIndicator I 0..1 Extension(boolean) Element id MedicationStatement.extension:pharmacistVerifiedIndicator
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
medicationPrescribingOrganization I 0..1 Extension(CodeableConcept) Element id MedicationStatement.extension:medicationPrescribingOrganization
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
medicationStatementLastIssueDate I 0..1 Extension(dateTime) Element id MedicationStatement.extension:medicationStatementLastIssueDate
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension MedicationStatement.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier MedicationStatement.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.identifier.id
extension I 0..* Extension MedicationStatement.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MedicationStatement.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MedicationStatement.identifier.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uri MedicationStatement.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 1..1 string MedicationStatement.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MedicationStatement.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id MedicationStatement.identifier.assigner
hasValue() or (children().count() > id.count())
basedOn Σ 0..* Reference( | | ) Element id MedicationStatement.basedOn
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.basedOn.id
extension I 0..* Extension MedicationStatement.basedOn.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MedicationStatement.basedOn.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MedicationStatement.basedOn.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MedicationStatement.basedOn.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.basedOn.identifier.id
extension I 0..* Extension MedicationStatement.basedOn.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MedicationStatement.basedOn.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MedicationStatement.basedOn.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MedicationStatement.basedOn.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MedicationStatement.basedOn.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MedicationStatement.basedOn.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id MedicationStatement.basedOn.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MedicationStatement.basedOn.display
hasValue() or (children().count() > id.count())
partOf Σ 0..* Reference( | | | | ) Element id MedicationStatement.partOf
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.partOf.id
extension I 0..* Extension MedicationStatement.partOf.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MedicationStatement.partOf.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MedicationStatement.partOf.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MedicationStatement.partOf.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.partOf.identifier.id
extension I 0..* Extension MedicationStatement.partOf.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MedicationStatement.partOf.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MedicationStatement.partOf.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MedicationStatement.partOf.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MedicationStatement.partOf.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MedicationStatement.partOf.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id MedicationStatement.partOf.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MedicationStatement.partOf.display
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding MedicationStatement.status
hasValue() or (children().count() > id.count())
statusReason 0..* CodeableConcept MedicationStatement.statusReason
hasValue() or (children().count() > id.count())
category Σ 0..1 CodeableConceptBinding Element id MedicationStatement.category
hasValue() or (children().count() > id.count())
medication[x] Σ 1..1 Binding Element id MedicationStatement.medication[x]
hasValue() or (children().count() > id.count())
medicationCodeableConcept CodeableConcept Data type medicationReference Reference() Data type subject Σ 1..1 Reference(Group | ) Element id MedicationStatement.subject
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.subject.id
extension I 0..* Extension MedicationStatement.subject.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MedicationStatement.subject.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MedicationStatement.subject.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MedicationStatement.subject.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.subject.identifier.id
extension I 0..* Extension MedicationStatement.subject.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MedicationStatement.subject.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MedicationStatement.subject.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MedicationStatement.subject.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MedicationStatement.subject.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MedicationStatement.subject.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id MedicationStatement.subject.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MedicationStatement.subject.display
hasValue() or (children().count() > id.count())
context Σ 0..1 Reference( | ) Element id MedicationStatement.context
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.context.id
extension I 0..* Extension MedicationStatement.context.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MedicationStatement.context.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MedicationStatement.context.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MedicationStatement.context.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.context.identifier.id
extension I 0..* Extension MedicationStatement.context.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MedicationStatement.context.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MedicationStatement.context.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MedicationStatement.context.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MedicationStatement.context.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MedicationStatement.context.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id MedicationStatement.context.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MedicationStatement.context.display
hasValue() or (children().count() > id.count())
effective[x] Σ 0..1 MedicationStatement.effective[x]
hasValue() or (children().count() > id.count())
effectiveDateTime dateTime effectivePeriod Period dateAsserted Σ 0..1 dateTime MedicationStatement.dateAsserted
hasValue() or (children().count() > id.count())
informationSource 0..1 Reference( | | | | ) Element id MedicationStatement.informationSource
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.informationSource.id
extension I 0..* Extension MedicationStatement.informationSource.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MedicationStatement.informationSource.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MedicationStatement.informationSource.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MedicationStatement.informationSource.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.informationSource.identifier.id
extension I 0..* Extension MedicationStatement.informationSource.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MedicationStatement.informationSource.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MedicationStatement.informationSource.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MedicationStatement.informationSource.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MedicationStatement.informationSource.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MedicationStatement.informationSource.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id MedicationStatement.informationSource.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MedicationStatement.informationSource.display
hasValue() or (children().count() > id.count())
derivedFrom 0..* Reference(Resource) MedicationStatement.derivedFrom
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.derivedFrom.id
extension I 0..* Extension MedicationStatement.derivedFrom.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MedicationStatement.derivedFrom.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MedicationStatement.derivedFrom.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MedicationStatement.derivedFrom.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.derivedFrom.identifier.id
extension I 0..* Extension MedicationStatement.derivedFrom.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MedicationStatement.derivedFrom.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MedicationStatement.derivedFrom.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MedicationStatement.derivedFrom.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MedicationStatement.derivedFrom.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MedicationStatement.derivedFrom.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id MedicationStatement.derivedFrom.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MedicationStatement.derivedFrom.display
hasValue() or (children().count() > id.count())
reasonCode 0..* CodeableConcept MedicationStatement.reasonCode
hasValue() or (children().count() > id.count())
reasonReference 0..* Reference( | ) Element id MedicationStatement.reasonReference
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.reasonReference.id
extension I 0..* Extension MedicationStatement.reasonReference.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MedicationStatement.reasonReference.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MedicationStatement.reasonReference.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MedicationStatement.reasonReference.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.reasonReference.identifier.id
extension I 0..* Extension MedicationStatement.reasonReference.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MedicationStatement.reasonReference.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MedicationStatement.reasonReference.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MedicationStatement.reasonReference.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MedicationStatement.reasonReference.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MedicationStatement.reasonReference.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id MedicationStatement.reasonReference.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MedicationStatement.reasonReference.display
hasValue() or (children().count() > id.count())
note 0..* Annotation MedicationStatement.note
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.note.id
extension I 0..* Extension MedicationStatement.note.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
author[x] Σ 0..1 MedicationStatement.note.author[x]
hasValue() or (children().count() > id.count())
authorString string Data type authorReference Reference( | | ) Data type time Σ 0..1 dateTime MedicationStatement.note.time
hasValue() or (children().count() > id.count())
text Σ 1..1 markdown MedicationStatement.note.text
hasValue() or (children().count() > id.count())
dosage 0..* Dosage MedicationStatement.dosage
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.dosage.id
extension I 0..* Extension MedicationStatement.dosage.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension MedicationStatement.dosage.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
sequence Σ 0..1 integer MedicationStatement.dosage.sequence
hasValue() or (children().count() > id.count())
text Σ 0..1 string MedicationStatement.dosage.text
hasValue() or (children().count() > id.count())
additionalInstruction Σ 0..* CodeableConcept MedicationStatement.dosage.additionalInstruction
hasValue() or (children().count() > id.count())
patientInstruction Σ 0..1 string MedicationStatement.dosage.patientInstruction
hasValue() or (children().count() > id.count())
timing Σ 0..1 Timing MedicationStatement.dosage.timing
hasValue() or (children().count() > id.count())
asNeeded[x] Σ 0..1 Binding Element id MedicationStatement.dosage.asNeeded[x]
hasValue() or (children().count() > id.count())
asNeededBoolean boolean asNeededCodeableConcept CodeableConcept site Σ 0..1 CodeableConceptBinding Element id MedicationStatement.dosage.site
hasValue() or (children().count() > id.count())
route Σ 0..1 CodeableConceptBinding Element id MedicationStatement.dosage.route
hasValue() or (children().count() > id.count())
method Σ 0..1 CodeableConceptBinding Element id MedicationStatement.dosage.method
hasValue() or (children().count() > id.count())
doseAndRate Σ 0..* Element MedicationStatement.dosage.doseAndRate
hasValue() or (children().count() > id.count())
id 0..1 string MedicationStatement.dosage.doseAndRate.id
extension I 0..* Extension MedicationStatement.dosage.doseAndRate.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
type Σ 0..1 CodeableConcept MedicationStatement.dosage.doseAndRate.type
hasValue() or (children().count() > id.count())
dose[x] Σ 0..1 MedicationStatement.dosage.doseAndRate.dose[x]
hasValue() or (children().count() > id.count())
doseRange Range doseQuantity SimpleQuantity rate[x] Σ 0..1 MedicationStatement.dosage.doseAndRate.rate[x]
hasValue() or (children().count() > id.count())
rateRatio Ratio rateRange Range rateQuantity SimpleQuantity maxDosePerPeriod Σ 0..1 Ratio MedicationStatement.dosage.maxDosePerPeriod
hasValue() or (children().count() > id.count())
maxDosePerAdministration Σ 0..1 SimpleQuantity MedicationStatement.dosage.maxDosePerAdministration
hasValue() or (children().count() > id.count())
maxDosePerLifetime Σ 0..1 SimpleQuantity MedicationStatement.dosage.maxDosePerLifetime
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
MedicationStatement
https://simplifier.net/hl7fhirukcorer4/ukcore-medicationstatement
0..*
MedicationStatement.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
89e4a6d0-4054-4267-b86a-b7cf55c0d941
MedicationStatement.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
MedicationStatement.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationStatement
MedicationStatement.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
MedicationStatement.status
Follow UK Core guidance for populating this element
MUST
1..1
active
MedicationStatement.category
MAY
0..1
MedicationStatement.category.coding
MUST
1..1
MedicationStatement.category.coding.system
Follow UK Core guidance for populating this element
MAY
0..1
http://terminology.hl7.org/CodeSystem/medication-statement-category
MedicationStatement.category.coding.code
Follow UK Core guidance for populating this element
MAY
0..1
outpatient
MedicationStatement.category.coding.display
Follow UK Core guidance for populating this element
MAY
0..1
Outpatient
MedicationStatement.medicationCodeableConcept
MUST
1..1
MedicationStatement.medicationCodeableConcept.coding
MedicationStatement.medicationCodeableConcept.coding.system
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
https://dmd.nhs.uk/
MedicationStatement.medicationCodeableConcept.coding.code
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
39732311000001104
MedicationStatement.medicationCodeableConcept.coding.display
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
Amoxicillin 250mg capsules
MedicationStatement.subject
MUST
1..1
MedicationStatement.subject.reference
This MUST be a reference to the patient
MUST
0..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
MedicationStatement.context
MAY
0..1
MedicationStatement.context.reference
Follow UK Core guidance for populating this element
MAY
0..1
urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
MedicationStatement.effectiveDateTime
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
2021-09-23
MedicationStatement.dateAsserted
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
2021-10-22
MedicationStatement.reasonCode
SHOULD
0..*
MedicationStatement.reasonCode.coding
MUST
1..1
MedicationStatement.reasonCode.coding.system
Follow UK Core guidance for populating this element
SHOULD
0..1
http://snomed.info/sct
MedicationStatement.reasonCode.coding.code
Follow UK Core guidance for populating this element
SHOULD
0..1
65363002
MedicationStatement.reasonCode.coding.display
Follow UK Core guidance for populating this element
SHOULD
0..1
Otitis Media
MedicationStatement.dosage
SHOULD
0..*
MedicationStatement.dosage.text
Follow UK Core guidance for populating this element
MAY
0..1
2 capsules 4 times a day.
MedicationStatement.dosage.timing
SHOULD
0..1
MedicationStatement.dosage.timing.repeat
MUST
0..1
MedicationStatement.dosage.timing.repeat.frequency
Follow UK Core guidance for populating this element
SHOULD
0..1
4
MedicationStatement.dosage.timing.repeat.period
Follow UK Core guidance for populating this element
SHOULD
0..1
1
MedicationStatement.dosage.timing.repeat.period unit
Follow UK Core guidance for populating this element
SHOULD
0..1
d
MedicationStatement.dosage.asNeededCodeableConcept
SHOULD
0..1
MedicationStatement.dosage.asNeededCodeableConcept.coding
MUST
1..1
MedicationStatement.dosage.asNeededCodeableConcept.coding.system
Follow UK Core guidance for populating this element
SHOULD
0..1
http://snomed.info/sct
MedicationStatement.dosage.asNeededCodeableConcept.coding.code
Follow UK Core guidance for populating this element
SHOULD
0..1
16001004
MedicationStatement.dosage.asNeededCodeableConcept.coding.display
Follow UK Core guidance for populating this element
SHOULD
0..1
Otalgia
MedicationStatement.dosage.site
MAY
0..1
MedicationStatement.dosage.site.coding
MUST
1..1
MedicationStatement.dosage.site.coding.system
Follow UK Core guidance for populating this element
MAY
0..1
http://snomed.info/sct
MedicationStatement.dosage.site.coding.code
Follow UK Core guidance for populating this element
MAY
0..1
123851003
MedicationStatement.dosage.site.coding.display
Follow UK Core guidance for populating this element
MAY
0..1
Mouth region structure
MedicationStatement.dosage.route
SHOULD
0..1
MedicationStatement.dosage.route.coding
MUST
1..1
MedicationStatement.dosage.route.coding.system
Follow UK Core guidance for populating this element
SHOULD
0..1
http://snomed.info/sct
MedicationStatement.dosage.route.coding.code
Follow UK Core guidance for populating this element
SHOULD
0..1
26643006
MedicationStatement.dosage.route.coding.display
Follow UK Core guidance for populating this element
SHOULD
0..1
Oral
MedicationStatement.dosage.method
SHOULD
0..*
MedicationStatement.dosage.method.coding
MUST
1..1
MedicationStatement.dosage.method.coding.system
Follow UK Core guidance for populating this element
SHOULD
0..1
http://snomed.info/sct
MedicationStatement.dosage.method.coding.code
Follow UK Core guidance for populating this element
SHOULD
0..1
421984009
MedicationStatement.dosage.method.coding.display
Follow UK Core guidance for populating this element
SHOULD
0..1
Until finished
MedicationStatement.dosage.doseAndRate
SHOULD
0..*
MedicationStatement.dosage.doseAndRate.doseQuantity
SHOULD
0..1
MedicationStatement.dosage.doseAndRate.doseQuantity.value
Follow UK Core guidance for populating this element
SHOULD
0..1
500
MedicationStatement.dosage.doseAndRate.doseQuantity.unit
Follow UK Core guidance for populating this element
SHOULD
0..1
milligram
MedicationStatement.dosage.doseAndRate.doseQuantity.system
Follow UK Core guidance for populating this element
SHOULD
0..1
http://unitsofmeasure.org
MedicationStatement.dosage.doseAndRate.doseQuantity.code
Follow UK Core guidance for populating this element
SHOULD
0..1
mg
This resource MAY be used to carry new Allergies confirmed at the senders encounter. This SHOULD NOT be used to carry Allergy History obtained from external sources. Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Allergy, Intolerance, Adverse Reaction Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance. Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Supports the date when the allergy or intolerance was no longer valid, and/or, the reason why the allergy or intolerance is no longer valid. extensions, user content Supports the date when the allergy or intolerance was no longer valid, and/or, the reason why the allergy or intolerance is no longer valid. 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. Extension(Complex) https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AllergyIntoleranceEnd A reference to results of investigations that confirmed the certainty of the diagnosis. extensions, user content A reference to results of investigations that confirmed the certainty of the diagnosis. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-Evidence Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. External ids for this item Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers. This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. active | inactive | resolved The clinical status of the allergy or intolerance. Refer to discussion if clincalStatus is missing data.
The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. The clinical status of the allergy or intolerance. unconfirmed | confirmed | refuted | entered-in-error Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product). The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity. Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. allergy | intolerance - Underlying mechanism (if known) Category, Class Identification of the underlying physiological mechanism for the reaction risk. Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource. Identification of the underlying physiological mechanism for a Reaction Risk. food | medication | environment | biologic Category, Type, Reaction Type, Class Category of the identified substance. This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender. Category of an identified substance associated with allergies or intolerances. low | high | unable-to-assess Severity, Seriousness, Contra-indication, Risk Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance. The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent. Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance. Code that identifies the allergy or intolerance Code Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies"). Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance. It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text. When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship. The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted. Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. Who the sensitivity is for Patient The patient who has the allergy or intolerance. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Encounter when the allergy or intolerance was asserted The encounter when the allergy or intolerance was asserted. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. When allergy or intolerance was identified Estimated or actual date, date-time, or age when allergy or intolerance was identified. Date first version of the resource instance was recorded The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date. Who recorded the sensitivity Author Individual who recorded the record and takes responsibility for its content. Reference( | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Source of the information about the allergy Source, Informant The source of the information about the allergy that is recorded. The recorder takes responsibility for the content, but can reference the source from where they got it. Reference( | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Date(/time) of last known occurrence of a reaction Represents the date and/or time of the last known occurrence of a reaction event. This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used. Additional text not captured in other fields Additional narrative about the propensity for the Adverse Reaction, not captured in other fields. For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Individual responsible for the annotation The individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment. Reference( | | | ) When the annotation was made Indicates when this particular annotation was made. The annotation - text content (as markdown) The text of the annotation in markdown format. Adverse Reaction Events linked to exposure to substance Details about each adverse reaction event linked to exposure to the identified substance. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Specific substance or pharmaceutical product considered to be responsible for event Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance. Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'. Codes defining the type of the substance (including pharmaceutical products). Clinical symptoms/signs associated with the Event Symptoms, Signs Clinical symptoms and/or signs that are observed or associated with the adverse reaction event. Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10. Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. Description of the event as a whole Narrative, Text Text description about the reaction as a whole, including details of the manifestation if required. Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives. Date(/time) when manifestations showed Record of the date and/or time of the onset of the Reaction. mild | moderate | severe (of event as a whole) Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations. It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions. Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations. How the subject was exposed to the substance Identification of the route by which the subject was exposed to the substance. Coding of the route of exposure with a terminology should be used wherever possible. A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. Text about event not captured in other fields Additional text about the adverse reaction event not captured in other fields. Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Individual responsible for the annotation The individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment. Reference( | | | ) When the annotation was made Indicates when this particular annotation was made. The annotation - text content (as markdown) The text of the annotation in markdown format.
> Allergy Intolerance
UKCoreAllergyIntolerance (AllergyIntolerance) I AllergyIntolerance AllergyIntolerance
verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string AllergyIntolerance.id
meta Σ 0..1 Meta AllergyIntolerance.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri AllergyIntolerance.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding AllergyIntolerance.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative AllergyIntolerance.text
hasValue() or (children().count() > id.count())
contained 0..* Resource AllergyIntolerance.contained
extension I 0..* Extension Element id AllergyIntolerance.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
allergyIntoleranceEnd I 0..1 Extension(Complex) Element id AllergyIntolerance.extension:allergyIntoleranceEnd
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
evidence I 0..* Extension(Reference()) Element id AllergyIntolerance.extension:evidence
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension AllergyIntolerance.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier AllergyIntolerance.identifier
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.identifier.id
extension I 0..* Extension AllergyIntolerance.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding AllergyIntolerance.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding AllergyIntolerance.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri AllergyIntolerance.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string AllergyIntolerance.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period AllergyIntolerance.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id AllergyIntolerance.identifier.assigner
hasValue() or (children().count() > id.count())
clinicalStatus Σ ?! I 0..1 CodeableConceptBinding AllergyIntolerance.clinicalStatus
hasValue() or (children().count() > id.count())
verificationStatus Σ ?! I 0..1 CodeableConceptBinding AllergyIntolerance.verificationStatus
hasValue() or (children().count() > id.count())
type Σ 0..1 codeBinding AllergyIntolerance.type
hasValue() or (children().count() > id.count())
category Σ 0..* codeBinding AllergyIntolerance.category
hasValue() or (children().count() > id.count())
criticality Σ 0..1 codeBinding AllergyIntolerance.criticality
hasValue() or (children().count() > id.count())
code Σ 1..1 CodeableConceptBinding Element id AllergyIntolerance.code
hasValue() or (children().count() > id.count())
patient Σ 1..1 Reference() Element id AllergyIntolerance.patient
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.patient.id
extension I 0..* Extension AllergyIntolerance.patient.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string AllergyIntolerance.patient.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding AllergyIntolerance.patient.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier AllergyIntolerance.patient.identifier
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.patient.identifier.id
extension I 0..* Extension AllergyIntolerance.patient.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding AllergyIntolerance.patient.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding AllergyIntolerance.patient.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri AllergyIntolerance.patient.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string AllergyIntolerance.patient.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period AllergyIntolerance.patient.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id AllergyIntolerance.patient.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string AllergyIntolerance.patient.display
hasValue() or (children().count() > id.count())
encounter 0..1 Reference() Element id AllergyIntolerance.encounter
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.encounter.id
extension I 0..* Extension AllergyIntolerance.encounter.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string AllergyIntolerance.encounter.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding AllergyIntolerance.encounter.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier AllergyIntolerance.encounter.identifier
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.encounter.identifier.id
extension I 0..* Extension AllergyIntolerance.encounter.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding AllergyIntolerance.encounter.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding AllergyIntolerance.encounter.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri AllergyIntolerance.encounter.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string AllergyIntolerance.encounter.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period AllergyIntolerance.encounter.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id AllergyIntolerance.encounter.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string AllergyIntolerance.encounter.display
hasValue() or (children().count() > id.count())
onset[x] 0..1 AllergyIntolerance.onset[x]
hasValue() or (children().count() > id.count())
onsetDateTime dateTime onsetAge Age onsetPeriod Period onsetRange Range onsetString string recordedDate 0..1 dateTime AllergyIntolerance.recordedDate
hasValue() or (children().count() > id.count())
recorder 0..1 Reference( | | | ) Element id AllergyIntolerance.recorder
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.recorder.id
extension I 0..* Extension AllergyIntolerance.recorder.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string AllergyIntolerance.recorder.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding AllergyIntolerance.recorder.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier AllergyIntolerance.recorder.identifier
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.recorder.identifier.id
extension I 0..* Extension AllergyIntolerance.recorder.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding AllergyIntolerance.recorder.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding AllergyIntolerance.recorder.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri AllergyIntolerance.recorder.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string AllergyIntolerance.recorder.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period AllergyIntolerance.recorder.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id AllergyIntolerance.recorder.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string AllergyIntolerance.recorder.display
hasValue() or (children().count() > id.count())
asserter Σ 0..1 Reference( | | | ) Element id AllergyIntolerance.asserter
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.asserter.id
extension I 0..* Extension AllergyIntolerance.asserter.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string AllergyIntolerance.asserter.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding AllergyIntolerance.asserter.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier AllergyIntolerance.asserter.identifier
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.asserter.identifier.id
extension I 0..* Extension AllergyIntolerance.asserter.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding AllergyIntolerance.asserter.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding AllergyIntolerance.asserter.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri AllergyIntolerance.asserter.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string AllergyIntolerance.asserter.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period AllergyIntolerance.asserter.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id AllergyIntolerance.asserter.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string AllergyIntolerance.asserter.display
hasValue() or (children().count() > id.count())
lastOccurrence 0..1 dateTime AllergyIntolerance.lastOccurrence
hasValue() or (children().count() > id.count())
note 0..* Annotation AllergyIntolerance.note
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.note.id
extension I 0..* Extension AllergyIntolerance.note.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
author[x] Σ 0..1 AllergyIntolerance.note.author[x]
hasValue() or (children().count() > id.count())
authorString string Data type authorReference Reference( | | | ) Data type time Σ 0..1 dateTime AllergyIntolerance.note.time
hasValue() or (children().count() > id.count())
text Σ 1..1 markdown AllergyIntolerance.note.text
hasValue() or (children().count() > id.count())
reaction 0..* BackboneElement AllergyIntolerance.reaction
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.reaction.id
extension I 0..* Extension AllergyIntolerance.reaction.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension AllergyIntolerance.reaction.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
substance 0..1 CodeableConceptBinding Element id AllergyIntolerance.reaction.substance
hasValue() or (children().count() > id.count())
manifestation 1..* CodeableConceptBinding Element id AllergyIntolerance.reaction.manifestation
hasValue() or (children().count() > id.count())
description 0..1 string AllergyIntolerance.reaction.description
hasValue() or (children().count() > id.count())
onset 0..1 dateTime AllergyIntolerance.reaction.onset
hasValue() or (children().count() > id.count())
severity 0..1 codeBinding AllergyIntolerance.reaction.severity
hasValue() or (children().count() > id.count())
exposureRoute 0..1 CodeableConceptBinding Element id AllergyIntolerance.reaction.exposureRoute
hasValue() or (children().count() > id.count())
note 0..* Annotation AllergyIntolerance.reaction.note
hasValue() or (children().count() > id.count())
id 0..1 string AllergyIntolerance.reaction.note.id
extension I 0..* Extension AllergyIntolerance.reaction.note.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
author[x] Σ 0..1 AllergyIntolerance.reaction.note.author[x]
hasValue() or (children().count() > id.count())
authorString string Data type authorReference Reference( | | | ) Data type time Σ 0..1 dateTime AllergyIntolerance.reaction.note.time
hasValue() or (children().count() > id.count())
text Σ 1..1 markdown AllergyIntolerance.reaction.note.text
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
AllergyIntolerance
https://simplifier.net/hl7fhirukcorer4/ukcore-allergyintolerance
0..*
AllergyIntolerance.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
12d61f8e-2239-4c56-add1-483d0b43559a
AllergyIntolerance.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
AllergyIntolerance.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-AllergyIntolerance
AllergyIntolerance.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
AllergyIntolerance.clinicalStatus
SHOULD
0..1
AllergyIntolerance.clinicalStatus.coding
MUST
1..1
AllergyIntolerance.clinicalStatus.coding.system
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
AllergyIntolerance.clinicalStatus.coding.code
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
active
AllergyIntolerance.clinicalStatus.coding.display
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
Active
AllergyIntolerance.verificationStatus
SHOULD
0..1
AllergyIntolerance.verificationStatus.coding
MUST
1..1
AllergyIntolerance.verificationStatus.coding.system
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
http://terminology.hl7.org/CodeSystem/allergyintolerance-verification
AllergyIntolerance.verificationStatus.coding.code
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
confirmed
AllergyIntolerance.verificationStatus.coding.display
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
Confirmed
AllergyIntolerance.type
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
allergy
AllergyIntolerance.category
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..*
medication
AllergyIntolerance.category.code
MUST
1..1
AllergyIntolerance.category.code.coding
MUST
1..1
AllergyIntolerance.category.code.coding.system
Follow UK Core guidance for populating this element
SHOULD
0..1
http://snomed.info.sct
AllergyIntolerance.category.code.coding.code
Follow UK Core guidance for populating this element
SHOULD
0..1
372687004
AllergyIntolerance.category.code.coding.display
Follow UK Core guidance for populating this element
SHOULD
0..1
Amoxicillin
AllergyIntolerance.patient
MUST
1..1
AllergyIntolerance.patient.reference
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
AllergyIntolerance.encounter
SHOULD
0..1
AllergyIntolerance.encounter.reference
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
AllergyIntolerance.recordedDate
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
2023-03-08T12:01:08.4677672+00:00
AllergyIntolerance.recorder
SHOULD
0..1
AllergyIntolerance.recorder.reference
Follow UK Core guidance for populating this element
MUST
1..1
urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
AllergyIntolerance.asserter
SHOULD
0..1
AllergyIntolerance.asserter.reference
Follow UK Core guidance for populating this element
MUST
1..1
Practitioner/UKCore-Practitioner-ConsultantSandraGose-Example
AllergyIntolerance.reaction
SHOULD
0..1
AllergyIntolerance.reaction.manifestation
MUST
1..*
AllergyIntolerance.reaction.manifestation.coding
MUST
1..1
AllergyIntolerance.reaction.manifestation.coding.system
Follow UK Core guidance for populating this element
SHOULD
0..1
http://snomed.info.sct
AllergyIntolerance.reaction.manifestation.coding.code
Follow UK Core guidance for populating this element
SHOULD
0..1
247472004
AllergyIntolerance.reaction.manifestation.coding.display
Follow UK Core guidance for populating this element
SHOULD
0..1
Urticarial rash
AllergyIntolerance.reaction.severity
Follow UK Core guidance for populating this element
SHOULD
0..1
mild
The Flag resource is used to convey risks and special patient requirements e.g. transport requirements, accessibility requirements, and reasonable adjustments. It can also be used to carry information about safeguarding concerns. Key information to flag to healthcare providers Barriers to Care, Alert, Warning Prospective warnings of potential issues when providing care to the patient. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Business identifier Business identifiers assigned to this flag by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Allows identification of the flag as it is known by various participating systems and in a way that remains consistent across servers. This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. active | inactive | entered-in-error Supports basic workflow. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Indicates whether this flag is active and needs to be displayed to a user, or whether it is no longer needed or was entered in error. Clinical, administrative, etc. Allows a flag to be divided into different categories like clinical, administrative etc. Intended to be used as a means of filtering which flags are displayed to particular user or in a given context. The value set will often need to be adjusted based on local business rules and usage context. A general category for flags for filtering/display purposes. Coded or textual message to display to user The coded value or textual component of the flag to display to the user. If non-coded, use CodeableConcept.text. This element should always be included in the narrative. Detail codes identifying specific flagged issues. Who/What is flag about? The patient, location, group, organization, or practitioner etc. this is about record this flag is associated with. Reference( | | | | | | Group | PlanDefinition) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Time period when flag is active The period of time from the activation of the flag to inactivation of the flag. If the flag is active, the end of the period should be unspecified. Alert relevant during encounter This alert is only relevant during the encounter. If both Flag.encounter and Flag.period are valued, then Flag.period.start shall not be before Encounter.period.start and Flag.period.end shall not be after Encounter.period.end. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Flag creator The person, organization or device that created the flag. Reference( | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
> Flag
UKCoreFlag (Flag) I Flag Flag
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Flag.id
meta Σ 0..1 Meta Flag.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Flag.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Flag.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Flag.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Flag.contained
extension I 0..* Extension Flag.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Flag.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Flag.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Flag.identifier.id
extension I 0..* Extension Flag.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Flag.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Flag.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Flag.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Flag.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Flag.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Flag.identifier.assigner
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding Flag.status
hasValue() or (children().count() > id.count())
category Σ 0..* CodeableConcept Flag.category
hasValue() or (children().count() > id.count())
code Σ 1..1 CodeableConcept Flag.code
hasValue() or (children().count() > id.count())
subject Σ 1..1 Reference( | | | | | | Group | PlanDefinition) Element id Flag.subject
hasValue() or (children().count() > id.count())
id 0..1 string Flag.subject.id
extension I 0..* Extension Flag.subject.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Flag.subject.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Flag.subject.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Flag.subject.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Flag.subject.identifier.id
extension I 0..* Extension Flag.subject.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Flag.subject.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Flag.subject.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Flag.subject.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Flag.subject.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Flag.subject.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Flag.subject.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Flag.subject.display
hasValue() or (children().count() > id.count())
period Σ 0..1 Period Flag.period
hasValue() or (children().count() > id.count())
encounter Σ 0..1 Reference() Element id Flag.encounter
hasValue() or (children().count() > id.count())
id 0..1 string Flag.encounter.id
extension I 0..* Extension Flag.encounter.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Flag.encounter.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Flag.encounter.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Flag.encounter.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Flag.encounter.identifier.id
extension I 0..* Extension Flag.encounter.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Flag.encounter.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Flag.encounter.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Flag.encounter.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Flag.encounter.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Flag.encounter.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Flag.encounter.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Flag.encounter.display
hasValue() or (children().count() > id.count())
author Σ 0..1 Reference( | | | | ) Element id Flag.author
hasValue() or (children().count() > id.count())
id 0..1 string Flag.author.id
extension I 0..* Extension Flag.author.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Flag.author.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Flag.author.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Flag.author.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Flag.author.identifier.id
extension I 0..* Extension Flag.author.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Flag.author.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Flag.author.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Flag.author.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Flag.author.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Flag.author.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Flag.author.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Flag.author.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
Flag
https://www.hl7.org/fhir/flag.html
0..*
Flag.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
77be46e3-7f01-4afe-b37d-7a301db6df63
Flag.meta
https://www.hl7.org/fhir/resource.html#Meta
1..1
Flag.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
http://hl7.org/fhir/StructureDefinition/Flag
Flag.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Flag.status
A status of 'active' MUST be assigned
MUST
1..1
active
Flag.category
MUST
0..*
Flag.category.coding
This MUST be populated with the overarching Flag Category: e.g. Safeguarding, Reasonable Adjustment, Rejected Services from CodeSystem 'https://fhir.nhs.uk/CodeSystem/flag-categories-bars'
MUST
1..1
Flag.category.coding.system
This MUST be populated with 'https://fhir.nhs.uk/CodeSystem/flag-categories-bars' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/flag-categories-bars
Flag.category.coding.code
This MUST be populated with the Code of the Flag Category. See CodeSystem https://fhir.nhs.uk/CodeSystem/flag-categories-bars
MUST
0..1
RA
Flag.category.coding.display
This MUST be populated with the Display of the Flag Category. See CodeSystem https://fhir.nhs.uk/CodeSystem/flag-categories-bars
MUST
0..1
Reasonable Adjustment
Flag.code
MUST
1..1
Flag.code.coding
This MUST be populated with the detail of what is being flagged in Flag Category. e.g. for Reasonable Adjustment (Flag Category): 'adjustforneedlephobia'(Code) 'Adjust for needle phobia'(Display). It would not be appropriate to indicate a Category of 'Safeguarding' and a Code of 'Reasonable Adjustment'. The Category and Code MUST correlate.
MUST
1..1
Flag.code.coding.system
This MUST be populated with the Coding System for what is being flagged e.g. https://fhir.nhs.uk/CodeSystem/reasonable-adjustment-codes-bars
MUST
0..1
https://fhir.nhs.uk/CodeSystem/reasonable-adjustment-codes-bars
Flag.code.coding.code
This MUST be populated with the relevant Code from the selected Flag code CodeSystem
MUST
0..1
adjustforneedlephobia
Flag.code.coding.display
This MUST be populated with the Display text from the Flag code CodeSystem
MUST
0..1
Adjust for needle phobia
Flag.subject
MUST
1..1
Flag.subject.reference
This MUST be populated with the subject that the flag refers to. Where the flag relates to the patient (e.g. reasonable adjustments) this will reference the Patient resource
MUST
1..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
Flag.period
SHOULD
0..1
Flag.period.start
Follow UK Core guidance for populating this element
SHOULD
0..1
2023-03-08T12:01:08.4677672+00:00
Flag.period.end
Follow UK Core guidance for populating this element
MAY
0..1
2023-03-08T12:01:08.4677672+00:00
This resource is used to communicate links to external sources of clinical information used in the triage/assessment of the patient that would be useful to the recipient. A structured set of questions and their answers Form, QuestionnaireAnswers A structured set of questions and their answers. The questions are ordered and grouped into coherent subsets, corresponding to the structure of the grouping of the questionnaire being responded to. The QuestionnaireResponse contains enough information about the questions asked and their organization that it can be interpreted somewhat independently from the Questionnaire it is based on. I.e. You don't need access to the Questionnaire in order to extract basic information from a QuestionnaireResponse. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unique id for this set of answers A business identifier assigned to a particular completed (or partially completed) questionnaire. Used for tracking, registration and other business purposes. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Request fulfilled by this QuestionnaireResponse order The order, proposal or plan that is fulfilled in whole or in part by this QuestionnaireResponse. For example, a ServiceRequest seeking an intake assessment or a decision support recommendation to assess for post-partum depression. Supports traceability of responsibility for the action and allows linkage of an action to the recommendations acted upon. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Part of this action A procedure or observation that this questionnaire was performed as part of the execution of. For example, the surgery a checklist was executed as part of. Composition of questionnaire responses will be handled by the parent questionnaire having answers that reference the child questionnaire. For relationships to referrals, and other types of requests, use basedOn. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Form being answered Form The Questionnaire that defines and organizes the questions for which answers are being provided. Needed to allow editing of the questionnaire response in a manner that enforces the constraints of the original form. If a QuestionnaireResponse references a Questionnaire, then the QuestionnaireResponse structure must be consistent with the Questionnaire (i.e. questions must be organized into the same groups, nested questions must still be nested, etc.). in-progress | completed | amended | entered-in-error | stopped The position of the questionnaire response within its overall lifecycle. The information on Questionnaire resources may possibly be gathered during multiple sessions and altered after considered being finished. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Lifecycle status of the questionnaire response. The subject of the questions Patient, Focus The subject of the questionnaire response. This could be a patient, organization, practitioner, device, etc. This is who/what the answers apply to, but is not necessarily the source of information. Allows linking the answers to the individual the answers describe. May also affect access control. If the Questionnaire declared a subjectType, the resource pointed to by this element must be an instance of one of the listed types. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Encounter created as part of The Encounter during which this questionnaire response was created or to which the creation of this record is tightly associated. Provides context for the information that was captured. May also affect access control. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. A questionnaire that was initiated during an encounter but not fully completed during the encounter would still generally be associated with the encounter. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Date the answers were gathered Date Created, Date published, Date Issued, Date updated The date and/or time that this set of answers were last changed. Clinicians need to be able to check the date that the information in the questionnaire was collected, to derive the context of the answers. May be different from the lastUpdateTime of the resource itself, because that reflects when the data was known to the server, not when the data was captured. This element is optional to allow for systems that might not know the value, however it SHOULD be populated if possible. Person who received and recorded the answers Laboratory, Service, Practitioner, Department, Company, Performer Person who received the answers to the questions in the QuestionnaireResponse and recorded them in the system. Need to know who interpreted the subject's answers to the questions in the questionnaire, and selected the appropriate options for answers. Mapping a subject's answers to multiple choice options and determining what to put in the textual answer is a matter of interpretation. Authoring by device would indicate that some portion of the questionnaire had been auto-populated. Reference( | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The person who answered the questions The person who answered the questions about the subject. When answering questions about a subject that is minor, incapable of answering or an animal, another human source may answer the questions. If not specified, no inference can be made about who provided the data. Reference( | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Groups and questions A group or question item from the original questionnaire for which answers are provided. Groups cannot have answers and therefore must nest directly within item. When dealing with questions, nesting must occur within each answer because some questions may have multiple answers (and the nesting occurs for each answer). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Pointer to specific item from Questionnaire The item from the Questionnaire that corresponds to this item in the QuestionnaireResponse resource. Items can repeat in the answers, so a direct 1..1 correspondence by position might not exist - requiring correspondence by identifier. ElementDefinition - details for the item A reference to an ElementDefinition that provides the details for the item. A common pattern is to define a set of data elements, and then build multiple different questionnaires for different circumstances to gather the data. This element provides traceability to the common definition. The ElementDefinition must be in a StructureDefinition, and must have a fragment identifier that identifies the specific data element by its id (Element.id). E.g. http://hl7.org/fhir/StructureDefinition/Observation#Observation.value[x]. There is no need for this element if the item pointed to by the linkId has a definition listed. Name for group or question text Text that is displayed above the contents of the group or as the text of the question being answered. Allows the questionnaire response to be read without access to the questionnaire. The response(s) to the question The respondent's answer(s) to the question. The value is nested because we cannot have a repeating structure that has variable type. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Single-valued answer to the question The answer (or one of the answers) provided by the respondent to the question. Ability to retain a single-valued answer to a question. More complex structures (Attachment, Resource and Quantity) will typically be limited to electronic forms that can expose an appropriate user interface to capture the components and enforce the constraints of a complex data type. Additional complex types can be introduced through extensions. Must match the datatype specified by Questionnaire.item.type in the corresponding Questionnaire. Code indicating the response provided for a question. Nested groups and questions Nested groups and/or questions found within this particular answer. It is useful to have "sub-questions", questions which normally appear when certain answers are given and which collect additional details. Nested questionnaire response items Questions or sub-groups nested beneath a question or group. Reports can consist of complex nested groups.> Questionnaire Response
UKCoreQuestionnaireResponse (QuestionnaireResponse) I QuestionnaireResponse QuestionnaireResponse
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string QuestionnaireResponse.id
meta Σ 0..1 Meta QuestionnaireResponse.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri QuestionnaireResponse.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding QuestionnaireResponse.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative QuestionnaireResponse.text
hasValue() or (children().count() > id.count())
contained 0..* Resource QuestionnaireResponse.contained
extension I 0..* Extension QuestionnaireResponse.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension QuestionnaireResponse.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..1 Identifier QuestionnaireResponse.identifier
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.identifier.id
extension I 0..* Extension QuestionnaireResponse.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding QuestionnaireResponse.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding QuestionnaireResponse.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri QuestionnaireResponse.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string QuestionnaireResponse.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period QuestionnaireResponse.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id QuestionnaireResponse.identifier.assigner
hasValue() or (children().count() > id.count())
basedOn Σ 0..* Reference( | ) Element id QuestionnaireResponse.basedOn
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.basedOn.id
extension I 0..* Extension QuestionnaireResponse.basedOn.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string QuestionnaireResponse.basedOn.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding QuestionnaireResponse.basedOn.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier QuestionnaireResponse.basedOn.identifier
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.basedOn.identifier.id
extension I 0..* Extension QuestionnaireResponse.basedOn.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding QuestionnaireResponse.basedOn.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding QuestionnaireResponse.basedOn.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri QuestionnaireResponse.basedOn.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string QuestionnaireResponse.basedOn.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period QuestionnaireResponse.basedOn.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id QuestionnaireResponse.basedOn.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string QuestionnaireResponse.basedOn.display
hasValue() or (children().count() > id.count())
partOf Σ 0..* Reference( | ) Element id QuestionnaireResponse.partOf
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.partOf.id
extension I 0..* Extension QuestionnaireResponse.partOf.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string QuestionnaireResponse.partOf.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding QuestionnaireResponse.partOf.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier QuestionnaireResponse.partOf.identifier
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.partOf.identifier.id
extension I 0..* Extension QuestionnaireResponse.partOf.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding QuestionnaireResponse.partOf.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding QuestionnaireResponse.partOf.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri QuestionnaireResponse.partOf.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string QuestionnaireResponse.partOf.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period QuestionnaireResponse.partOf.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id QuestionnaireResponse.partOf.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string QuestionnaireResponse.partOf.display
hasValue() or (children().count() > id.count())
questionnaire Σ 0..1 canonical() Element id QuestionnaireResponse.questionnaire
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding QuestionnaireResponse.status
hasValue() or (children().count() > id.count())
subject Σ 0..1 Reference(Resource) QuestionnaireResponse.subject
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.subject.id
extension I 0..* Extension QuestionnaireResponse.subject.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string QuestionnaireResponse.subject.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding QuestionnaireResponse.subject.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier QuestionnaireResponse.subject.identifier
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.subject.identifier.id
extension I 0..* Extension QuestionnaireResponse.subject.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding QuestionnaireResponse.subject.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding QuestionnaireResponse.subject.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri QuestionnaireResponse.subject.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string QuestionnaireResponse.subject.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period QuestionnaireResponse.subject.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id QuestionnaireResponse.subject.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string QuestionnaireResponse.subject.display
hasValue() or (children().count() > id.count())
encounter Σ 0..1 Reference() Element id QuestionnaireResponse.encounter
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.encounter.id
extension I 0..* Extension QuestionnaireResponse.encounter.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string QuestionnaireResponse.encounter.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding QuestionnaireResponse.encounter.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier QuestionnaireResponse.encounter.identifier
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.encounter.identifier.id
extension I 0..* Extension QuestionnaireResponse.encounter.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding QuestionnaireResponse.encounter.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding QuestionnaireResponse.encounter.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri QuestionnaireResponse.encounter.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string QuestionnaireResponse.encounter.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period QuestionnaireResponse.encounter.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id QuestionnaireResponse.encounter.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string QuestionnaireResponse.encounter.display
hasValue() or (children().count() > id.count())
authored Σ 0..1 dateTime QuestionnaireResponse.authored
hasValue() or (children().count() > id.count())
author Σ 0..1 Reference( | | | | | ) Element id QuestionnaireResponse.author
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.author.id
extension I 0..* Extension QuestionnaireResponse.author.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string QuestionnaireResponse.author.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding QuestionnaireResponse.author.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier QuestionnaireResponse.author.identifier
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.author.identifier.id
extension I 0..* Extension QuestionnaireResponse.author.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding QuestionnaireResponse.author.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding QuestionnaireResponse.author.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri QuestionnaireResponse.author.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string QuestionnaireResponse.author.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period QuestionnaireResponse.author.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id QuestionnaireResponse.author.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string QuestionnaireResponse.author.display
hasValue() or (children().count() > id.count())
source Σ 0..1 Reference( | | | ) Element id QuestionnaireResponse.source
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.source.id
extension I 0..* Extension QuestionnaireResponse.source.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string QuestionnaireResponse.source.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding QuestionnaireResponse.source.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier QuestionnaireResponse.source.identifier
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.source.identifier.id
extension I 0..* Extension QuestionnaireResponse.source.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding QuestionnaireResponse.source.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding QuestionnaireResponse.source.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri QuestionnaireResponse.source.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string QuestionnaireResponse.source.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period QuestionnaireResponse.source.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id QuestionnaireResponse.source.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string QuestionnaireResponse.source.display
hasValue() or (children().count() > id.count())
item I 0..* BackboneElement QuestionnaireResponse.item
hasValue() or (children().count() > id.count())
(answer.exists() and item.exists()).not()
id 0..1 string QuestionnaireResponse.item.id
extension I 0..* Extension QuestionnaireResponse.item.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension QuestionnaireResponse.item.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
linkId 1..1 string QuestionnaireResponse.item.linkId
hasValue() or (children().count() > id.count())
definition 0..1 uri QuestionnaireResponse.item.definition
hasValue() or (children().count() > id.count())
text 0..1 string QuestionnaireResponse.item.text
hasValue() or (children().count() > id.count())
answer 0..* BackboneElement QuestionnaireResponse.item.answer
hasValue() or (children().count() > id.count())
id 0..1 string QuestionnaireResponse.item.answer.id
extension I 0..* Extension QuestionnaireResponse.item.answer.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension QuestionnaireResponse.item.answer.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
value[x] 0..1 QuestionnaireResponse.item.answer.value[x]
hasValue() or (children().count() > id.count())
valueBoolean boolean valueDecimal decimal valueInteger integer valueDate date valueDateTime dateTime valueTime time valueString string valueUri uri valueAttachment Attachment valueCoding Coding valueQuantity Quantity valueReference Reference(Resource) item 0..* see (item) QuestionnaireResponse.item.answer.item
hasValue() or (children().count() > id.count())
item 0..* see (item) QuestionnaireResponse.item.item
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
QuestionnaireResponse
https://simplifier.net/hl7fhirukcorer4/ukcore-questionnaireresponse
0..*
QuestionnaireResponse.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
65508934-c9e6-46d2-a393-af096b502daf
QuestionnaireResponse.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
QuestionnaireResponse.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-QuestionnaireResponse
QuestionnaireResponse.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
QuestionnaireResponse.extension
MUST
0..*
QuestionnaireResponse.extension.url
This MUST be populated with Structure Definition 'http://hl7.org/fhir/StructureDefinition/questionnaireresponse-reason' - FIXED VALUE
MUST
1..1
http://hl7.org/fhir/StructureDefinition/questionnaireresponse-reason
QuestionnaireResponse.extension.valueCodeableConcept
MUST
0..*
QuestionnaireResponse.extension.valueCodeableConcept.text
This MUST be populated to Indicate the type of QuestionnaireResponse e.g.
EITHER 'Rejected Services - Patient Choice in Service Selection' for Rejected Services
OR 'Additional Information Sources' for Additional Information SourcesMUST
0..1
Rejected Services - Patient Choice in Service Selection
QuestionnaireResponse.basedOn
SHOULD
0..*
QuestionnaireResponse.basedOn.reference
This SHOULD be populated with EITHER reference to ServiceRequest for 'Rejected Services' OR CarePlan for 'Additional Information Services'
SHOULD
0..1
urn:uuid:236bb75d-90ef-461f-b71e-fde7f899802c
QuestionnaireResponse.subject
Follow UK Core guidance for populating this element
MUST
0..1
QuestionnaireResponse.subject.reference
Flag resource for 'Rejected Services' or Patient for 'Additional Information Services'
MUST
0..1
urn:uuid:41e591ab-d333-4fb8-87b4-d35f740b6bfc
QuestionnaireResponse.authored
Date/Time added during encounter
MAY
0..1
2023-03-08T12:01:08.4677672+00:00
QuestionnaireResponse.author
Follow UK Core guidance for populating this element
SHOULD
0..1
QuestionnaireResponse.author.reference
This SHOULD be populated with a reference to the Practitioner who created as part of the assessment
SHOULD
0..1
urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
QuestionnaireResponse.source
Follow UK Core guidance for populating this element
SHOULD
0..1
QuestionnaireResponse.source.reference
This SHOULD be populated with a reference to the Patient resource when either they or a related third party (e.g. carer, parent, etc.) answers the questions. Alternatively, if a clinical representative for the patient answers, a reference to a Practitioner resource is permissable.
SHOULD
0..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
QuestionnaireResponse.item
This MUST be populated with the overarching Item array
MUST
0..*
QuestionnaireResponse.item.linkid
This MUST be populated with the type of item EITHER 'RejectedServices' OR 'AdditionalSources'
MUST
1..1
RejectedServices
QuestionnaireResponse.item.text
This MUST be populated with a description of item
MUST
0..1
RejectedServices
QuestionnaireResponse.item.item
This MUST be populated with the Specific Item
MUST
0..*
QuestionnaireResponse.item.item.linkid
Thid MUST be populated with EITHER Service
MUST
1..1
Service1
QuestionnaireResponse.item.item.item
This MUST be populated with the Elements within the above 'item' within an array e.g. EITHER DoS Service ID, DoS Service Name, Reject Reason and Rejection Comment for 'RejectedServices' OR Additional Source Name (e.g. MIG) and Additional Source URL for 'AdditionalSources'
MUST
0..1
QuestionnaireResponse.item.item.item.linkid
This MUST be populated with EITHER the ServiceId for 'RejectedServices' OR SourceName for 'AdditionalSources'. In the case of 'AdditionalSources', this could either be 3rd party source i.e. Graphnet or a local Special-Patient-Note (SPN)
MUST
1..1
ServiceId
QuestionnaireResponse.item.item.item.answer
This MUST be populated with the Specific answer
MUST
0..*
QuestionnaireResponse.item.item.item.answer.valueString
This MUST be populated with the answer Value for the item declared above EITHER the DoS Service ID for 'RejectedServices' OR Source name e.g. 'Graphnet' for 'AdditionalSources'
MUST
0..1
200000359
QuestionnaireResponse.item.item.item.linkid
This MUST be populated with ServiceName for 'RejectedServices', SourceURL for 'AdditionalSources' or, where the 'AdditionalSource' is a Special-Patient-Note (SPN), 'SPNTitle'
MUST
1..1
ServiceName
QuestionnaireResponse.item.item.item.answer
This MUST be populated with the Specific answer
MUST
0..*
QuestionnaireResponse.item.item.item.answer.valueString
This MUST be populated with the answer Value for the item declared above EITHER the DoS Service Name for 'RejectedServices', SourceURL for 'AdditionalSources' OR, where the 'AdditionalSource' is a Special-Patient-Note (SPN), the overall name of the SPN
MUST
0..1
Test DoS Service
QuestionnaireResponse.item.item.item.linkid
This MUST be populated with the RejectionReason for 'RejectedServices' or, where the 'AdditionalSource' is a Special-Patient-Note (SPN), the title for information wishing to be carried, for example, the SPN note text. SPN answers can continue to nest, assigning the appropriate answer.value
MUST
1..1
RejectionReason
QuestionnaireResponse.item.item.item.answer
This MUST be populated with the Specific answer
MUST
0..*
QuestionnaireResponse.item.item.item.answer.valueCoding.system
This MUST be populated with 'https://fhir.nhs.uk/CodeSystem/dos-rejected-reasons-bars' for 'RejectedServices'
MUST
0..1
https://fhir.nhs.uk/CodeSystem/dos-rejected-reasons-bars
QuestionnaireResponse.item.item.item.answer.valueCoding.code
For 'RejectedServices' this MUST be a value from the above CodeSystem
MUST
0..1
26
QuestionnaireResponse.item.item.item.answer.valueCoding.display
For 'RejectedServices' this MUST be the corresponding display text for the above Code from the specified CodeSystem
MUST
0..1
Rejected for patient choice
QuestionnaireResponse.item.item.item.linkid
If an optional comment for the above Rejected Service is recorded this MUST be included and this linkid value MUST be 'RejectionComment'
MUST
1..1
RejectionComment
QuestionnaireResponse.item.item.item.answer
This MUST be populated with the Specific answer
MUST
0..*
QuestionnaireResponse.item.item.item.answer.valueString
The text string for the Reject Service MUST be recorded here
MUST
0..1
Patient refused service due to parking
This resource can be used to communicate measurements and simple assertions made about a patient. Measurements and simple assertions Vital Signs, Measurement, Results, Tests Measurements and simple assertions made about a patient, device or other subject. Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Business Identifier for observation A unique identifier assigned to this observation. Allows observations to be distinguished and referenced. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Fulfills plan, proposal or order Fulfills A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed. Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon. Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Part of referenced event Container A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure. To link an Observation to an Encounter use Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. registered | preliminary | final | amended + The status of the result value. Need to track the status of individual results. Some results are finalized before the whole report is finalized. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. Codes providing the status of an observation. Classification of type of observation A code that classifies the general type of observation being made. Used for filtering what observations are retrieved and displayed. In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set. Codes for high level observation categories. Type of observation (code / type) Name Describes what was observed. Sometimes this is called the observation "name". Knowing what kind of observation is being made is essential to understanding the observation. All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. Codes identifying names of simple observations. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by system(Value) Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. A code from the SNOMED Clinical Terminology UK coding system describing a type of observation Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Identity of the terminology system The identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Version of the system - if relevant The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Symbol in syntax defined by the system A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Representation defined by the system A representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. If this coding was chosen directly by the user Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Identity of the terminology system The identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Version of the system - if relevant The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Symbol in syntax defined by the system A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Representation defined by the system A representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. If this coding was chosen directly by the user Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Plain text representation of the concept A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings. Who and/or what the observation is about The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the Observations have no value if you don't know who or what they're about. One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated. Reference(Group | Device | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. What the observation is about, when it is not about the subject of record The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus. Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Healthcare event during which this observation is made Context The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made. For some observations it may be important to know the link between an observation and a particular encounter. This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Clinically relevant time/time-period for observation Occurrence The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself. Knowing when an observation was deemed true is important to its relevance as well as determining trends. At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events. Date/Time this version was made available The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified. For Observations that don’t require review and verification, it may be the same as the Who is responsible for the observation Who was responsible for asserting the observed value as "true". May give a degree of confidence in the observation and also indicates where follow-up questions should be directed. Reference(CareTeam | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Actual result The information determined as a result of making the observation, if the information has a simple value. An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below. Why the result is missing Provides a reason why the expected value in the element Observation.value[x] is missing. For many results it is necessary to handle exceptional values in measurements. Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values. Codes specifying why the result ( High, low, normal, etc. Abnormal Flag A categorical assessment of an observation value. For example, high, low, normal. For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result. Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Codes identifying interpretations of observations. Comments about the observation Comments about the observation or the results. Need to be able to provide free text additional information. May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Individual responsible for the annotation The individual responsible for making the annotation. Organization is used when there's no need for specific attribution as to who made the comment. Reference( | | | ) When the annotation was made Indicates when this particular annotation was made. The annotation - text content (as markdown) The text of the annotation in markdown format. Observed body part Indicates the site on the subject's body where the observation was made (i.e. the target site). Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite. Codes describing anatomical locations. May include laterality. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by code(Value), system(Value) Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. A code from the SNOMED Clinical Terminology UK with the expression (<<442083009 |anatomical or acquired body structure|) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Identity of the terminology system The identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Version of the system - if relevant The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Symbol in syntax defined by the system A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Representation defined by the system A representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. If this coding was chosen directly by the user Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Plain text representation of the concept A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings. How it was done Indicates the mechanism used to perform the observation. In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results. Only used if not implicit in code for Observation.code. Methods for simple observations. Specimen used for this observation The specimen that was used when this observation was made. Should only be used if not implicit in code found in Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. (Measurement) Device The device used to generate the observation data. Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant. Reference(Device | DeviceMetric) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Provides guide for interpretation Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts. Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Low Range, if relevant The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3). High Range, if relevant The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3). Reference range qualifier Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range. Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation. This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed. Code for the meaning of a reference range. Reference range population Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple Need to be able to identify the target population for proper interpretation. This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed. Codes identifying the population the reference range applies to. Applicable age range, if relevant The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so. Some analytes vary greatly over age. Text based reference range in an observation Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals". Related resource that belongs to the Observation group This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group. When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation. Reference(QuestionnaireResponse | MolecularSequence | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Related measurements the observation is made from The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image. All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below. Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Component results Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations. Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation. For a discussion on the ways Observations can be assembled in groups together see Notes below. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Type of component observation (code / type) Describes what was observed. Sometimes this is called the observation "code". Knowing what kind of observation is being made is essential to understanding the observation. All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. Codes identifying names of simple observations. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by code(Value), system(Value) Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. A code from the SNOMED Clinical Terminology UK coding system describing a type of observation Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Identity of the terminology system The identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. Version of the system - if relevant The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Symbol in syntax defined by the system A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Representation defined by the system A representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. If this coding was chosen directly by the user Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Plain text representation of the concept A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings. Actual component result The information determined as a result of making the observation, if the information has a simple value. An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations. Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below. Why the component result is missing Provides a reason why the expected value in the element Observation.component.value[x] is missing. For many results it is necessary to handle exceptional values in measurements. "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values. Codes specifying why the result ( High, low, normal, etc. Abnormal Flag A categorical assessment of an observation value. For example, high, low, normal. For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result. Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Codes identifying interpretations of observations. Provides guide for interpretation of component result Guidance on how to interpret the value by comparison to a normal or recommended range. Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts. Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.> Observation
UKCoreObservation (Observation) I Observation Observation
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
dataAbsentReason.empty() or value.empty()
value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
id Σ 0..1 string Observation.id
meta Σ 0..1 Meta Observation.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Observation.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Observation.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Observation.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Observation.contained
extension I 0..* Extension Observation.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Observation.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Observation.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.identifier.id
extension I 0..* Extension Observation.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.identifier.assigner
hasValue() or (children().count() > id.count())
basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Observation.basedOn
hasValue() or (children().count() > id.count())
id 0..1 string Observation.basedOn.id
extension I 0..* Extension Observation.basedOn.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.basedOn.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.basedOn.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.basedOn.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.basedOn.identifier.id
extension I 0..* Extension Observation.basedOn.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.basedOn.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.basedOn.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.basedOn.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.basedOn.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.basedOn.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.basedOn.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.basedOn.display
hasValue() or (children().count() > id.count())
partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Observation.partOf
encounter
. See the Notes below for guidance on referencing another Observation.hasValue() or (children().count() > id.count())
id 0..1 string Observation.partOf.id
extension I 0..* Extension Observation.partOf.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.partOf.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.partOf.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.partOf.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.partOf.identifier.id
extension I 0..* Extension Observation.partOf.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.partOf.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.partOf.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.partOf.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.partOf.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.partOf.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.partOf.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.partOf.display
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding Observation.status
hasValue() or (children().count() > id.count())
category 0..* CodeableConceptBinding Observation.category
hasValue() or (children().count() > id.count())
code Σ 1..1 CodeableConcept Observation.code
hasValue() or (children().count() > id.count())
id 0..1 string Observation.code.id
extension I 0..* Extension Observation.code.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
coding Σ 0..* Coding Element id Observation.code.coding
hasValue() or (children().count() > id.count())
snomedCT Σ 0..* CodingBinding Element id Observation.code.coding:snomedCT
hasValue() or (children().count() > id.count())
id 0..1 string Observation.code.coding:snomedCT.id
extension I 0..* Extension Observation.code.coding:snomedCT.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ 1..1 uriFixed Value Element id Observation.code.coding:snomedCT.system
hasValue() or (children().count() > id.count())
http://snomed.info/sct
version Σ 0..1 string Observation.code.coding:snomedCT.version
hasValue() or (children().count() > id.count())
code Σ 1..1 code Observation.code.coding:snomedCT.code
hasValue() or (children().count() > id.count())
display Σ 1..1 string Observation.code.coding:snomedCT.display
hasValue() or (children().count() > id.count())
userSelected Σ 0..1 boolean Observation.code.coding:snomedCT.userSelected
hasValue() or (children().count() > id.count())
loinc Σ 0..* Coding Observation.code.coding:loinc
hasValue() or (children().count() > id.count())
id 0..1 string Observation.code.coding:loinc.id
extension I 0..* Extension Observation.code.coding:loinc.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ 1..1 uriFixed Value Element id Observation.code.coding:loinc.system
hasValue() or (children().count() > id.count())
http://loinc.org
version Σ 0..1 string Observation.code.coding:loinc.version
hasValue() or (children().count() > id.count())
code Σ 1..1 code Observation.code.coding:loinc.code
hasValue() or (children().count() > id.count())
display Σ 1..1 string Observation.code.coding:loinc.display
hasValue() or (children().count() > id.count())
userSelected Σ 0..1 boolean Observation.code.coding:loinc.userSelected
hasValue() or (children().count() > id.count())
text Σ 0..1 string Observation.code.text
hasValue() or (children().count() > id.count())
subject Σ 0..1 Reference(Group | Device | | ) Element id Observation.subject
focus
element or the code
itself specifies the actual focus of the observation.hasValue() or (children().count() > id.count())
id 0..1 string Observation.subject.id
extension I 0..* Extension Observation.subject.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.subject.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.subject.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.subject.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.subject.identifier.id
extension I 0..* Extension Observation.subject.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.subject.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.subject.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.subject.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.subject.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.subject.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.subject.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.subject.display
hasValue() or (children().count() > id.count())
focus Σ 0..* Reference(Resource) Observation.focus
specimen
if a reference to a specimen is required. If a code is required instead of a resource use either bodysite
for bodysites or the standard extension focusCode.hasValue() or (children().count() > id.count())
id 0..1 string Observation.focus.id
extension I 0..* Extension Observation.focus.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.focus.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.focus.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.focus.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.focus.identifier.id
extension I 0..* Extension Observation.focus.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.focus.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.focus.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.focus.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.focus.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.focus.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.focus.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.focus.display
hasValue() or (children().count() > id.count())
encounter Σ 0..1 Reference() Element id Observation.encounter
hasValue() or (children().count() > id.count())
id 0..1 string Observation.encounter.id
extension I 0..* Extension Observation.encounter.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.encounter.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.encounter.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.encounter.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.encounter.identifier.id
extension I 0..* Extension Observation.encounter.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.encounter.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.encounter.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.encounter.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.encounter.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.encounter.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.encounter.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.encounter.display
hasValue() or (children().count() > id.count())
effective[x] Σ 0..1 Observation.effective[x]
hasValue() or (children().count() > id.count())
effectiveDateTime dateTime effectivePeriod Period effectiveTiming Timing effectiveInstant instant issued Σ 0..1 instant Observation.issued
lastUpdated
time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated
time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.hasValue() or (children().count() > id.count())
performer Σ 0..* Reference(CareTeam | | | | | ) Element id Observation.performer
hasValue() or (children().count() > id.count())
id 0..1 string Observation.performer.id
extension I 0..* Extension Observation.performer.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.performer.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.performer.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.performer.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.performer.identifier.id
extension I 0..* Extension Observation.performer.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.performer.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.performer.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.performer.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.performer.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.performer.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.performer.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.performer.display
hasValue() or (children().count() > id.count())
value[x] Σ I 0..1 Observation.value[x]
hasValue() or (children().count() > id.count())
valueQuantity Quantity valueCodeableConcept CodeableConcept valueString string valueBoolean boolean valueInteger integer valueRange Range valueRatio Ratio valueSampledData SampledData valueTime time valueDateTime dateTime valuePeriod Period dataAbsentReason I 0..1 CodeableConceptBinding Observation.dataAbsentReason
Observation.value[x]
) is missing.hasValue() or (children().count() > id.count())
interpretation 0..* CodeableConceptBinding Observation.interpretation
hasValue() or (children().count() > id.count())
note 0..* Annotation Observation.note
hasValue() or (children().count() > id.count())
id 0..1 string Observation.note.id
extension I 0..* Extension Observation.note.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
author[x] Σ 0..1 Observation.note.author[x]
hasValue() or (children().count() > id.count())
authorString string Data type authorReference Reference( | | | ) Data type time Σ 0..1 dateTime Observation.note.time
hasValue() or (children().count() > id.count())
text Σ 1..1 markdown Observation.note.text
hasValue() or (children().count() > id.count())
bodySite 0..1 CodeableConcept Observation.bodySite
hasValue() or (children().count() > id.count())
id 0..1 string Observation.bodySite.id
extension I 0..* Extension Observation.bodySite.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
coding Σ 0..* Coding Element id Observation.bodySite.coding
hasValue() or (children().count() > id.count())
snomedCT Σ 0..1 CodingBinding Element id Observation.bodySite.coding:snomedCT
hasValue() or (children().count() > id.count())
id 0..1 string Observation.bodySite.coding:snomedCT.id
extension I 0..* Extension Observation.bodySite.coding:snomedCT.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ 1..1 uriFixed Value Element id Observation.bodySite.coding:snomedCT.system
hasValue() or (children().count() > id.count())
http://snomed.info/sct
version Σ 0..1 string Observation.bodySite.coding:snomedCT.version
hasValue() or (children().count() > id.count())
code Σ 1..1 code Observation.bodySite.coding:snomedCT.code
hasValue() or (children().count() > id.count())
display Σ 1..1 string Observation.bodySite.coding:snomedCT.display
hasValue() or (children().count() > id.count())
userSelected Σ 0..1 boolean Observation.bodySite.coding:snomedCT.userSelected
hasValue() or (children().count() > id.count())
text Σ 0..1 string Observation.bodySite.text
hasValue() or (children().count() > id.count())
method 0..1 CodeableConceptBinding Element id Observation.method
hasValue() or (children().count() > id.count())
specimen 0..1 Reference(Specimen) Observation.specimen
Observation.code
. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).hasValue() or (children().count() > id.count())
id 0..1 string Observation.specimen.id
extension I 0..* Extension Observation.specimen.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.specimen.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.specimen.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.specimen.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.specimen.identifier.id
extension I 0..* Extension Observation.specimen.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.specimen.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.specimen.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.specimen.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.specimen.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.specimen.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.specimen.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.specimen.display
hasValue() or (children().count() > id.count())
device 0..1 Reference(Device | DeviceMetric) Observation.device
hasValue() or (children().count() > id.count())
id 0..1 string Observation.device.id
extension I 0..* Extension Observation.device.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.device.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.device.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.device.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.device.identifier.id
extension I 0..* Extension Observation.device.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.device.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.device.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.device.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.device.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.device.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.device.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.device.display
hasValue() or (children().count() > id.count())
referenceRange I 0..* BackboneElement Observation.referenceRange
referenceRange
elements would be used.hasValue() or (children().count() > id.count())
low.exists() or high.exists() or text.exists()
id 0..1 string Observation.referenceRange.id
extension I 0..* Extension Observation.referenceRange.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Observation.referenceRange.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
low I 0..1 SimpleQuantity Observation.referenceRange.low
hasValue() or (children().count() > id.count())
high I 0..1 SimpleQuantity Observation.referenceRange.high
hasValue() or (children().count() > id.count())
type 0..1 CodeableConceptBinding Observation.referenceRange.type
hasValue() or (children().count() > id.count())
appliesTo 0..* CodeableConcept Observation.referenceRange.appliesTo
appliesTo
are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.hasValue() or (children().count() > id.count())
age 0..1 Range Observation.referenceRange.age
hasValue() or (children().count() > id.count())
text 0..1 string Observation.referenceRange.text
hasValue() or (children().count() > id.count())
hasMember Σ 0..* Reference(QuestionnaireResponse | MolecularSequence | ) Element id Observation.hasMember
hasValue() or (children().count() > id.count())
id 0..1 string Observation.hasMember.id
extension I 0..* Extension Observation.hasMember.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.hasMember.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.hasMember.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.hasMember.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.hasMember.identifier.id
extension I 0..* Extension Observation.hasMember.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.hasMember.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.hasMember.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.hasMember.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.hasMember.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.hasMember.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.hasMember.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.hasMember.display
hasValue() or (children().count() > id.count())
derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | MolecularSequence | ) Element id Observation.derivedFrom
hasValue() or (children().count() > id.count())
id 0..1 string Observation.derivedFrom.id
extension I 0..* Extension Observation.derivedFrom.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Observation.derivedFrom.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Observation.derivedFrom.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Observation.derivedFrom.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Observation.derivedFrom.identifier.id
extension I 0..* Extension Observation.derivedFrom.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Observation.derivedFrom.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Observation.derivedFrom.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Observation.derivedFrom.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Observation.derivedFrom.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Observation.derivedFrom.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Observation.derivedFrom.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Observation.derivedFrom.display
hasValue() or (children().count() > id.count())
component Σ 0..* BackboneElement Observation.component
hasValue() or (children().count() > id.count())
id 0..1 string Observation.component.id
extension I 0..* Extension Observation.component.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Observation.component.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
code Σ 1..1 CodeableConcept Observation.component.code
hasValue() or (children().count() > id.count())
id 0..1 string Observation.component.code.id
extension I 0..* Extension Observation.component.code.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
coding Σ 0..* Coding Element id Observation.component.code.coding
hasValue() or (children().count() > id.count())
snomedCT Σ 0..* CodingBinding Element id Observation.component.code.coding:snomedCT
hasValue() or (children().count() > id.count())
id 0..1 string Observation.component.code.coding:snomedCT.id
extension I 0..* Extension Observation.component.code.coding:snomedCT.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ 1..1 uriFixed Value Element id Observation.component.code.coding:snomedCT.system
hasValue() or (children().count() > id.count())
http://snomed.info/sct
version Σ 0..1 string Observation.component.code.coding:snomedCT.version
hasValue() or (children().count() > id.count())
code Σ 1..1 code Observation.component.code.coding:snomedCT.code
hasValue() or (children().count() > id.count())
display Σ 1..1 string Observation.component.code.coding:snomedCT.display
hasValue() or (children().count() > id.count())
userSelected Σ 0..1 boolean Observation.component.code.coding:snomedCT.userSelected
hasValue() or (children().count() > id.count())
text Σ 0..1 string Observation.component.code.text
hasValue() or (children().count() > id.count())
value[x] Σ 0..1 Observation.component.value[x]
hasValue() or (children().count() > id.count())
valueQuantity Quantity valueCodeableConcept CodeableConcept valueString string valueBoolean boolean valueInteger integer valueRange Range valueRatio Ratio valueSampledData SampledData valueTime time valueDateTime dateTime valuePeriod Period dataAbsentReason I 0..1 CodeableConceptBinding Observation.component.dataAbsentReason
Observation.value[x]
) is missing.hasValue() or (children().count() > id.count())
interpretation 0..* CodeableConceptBinding Observation.component.interpretation
hasValue() or (children().count() > id.count())
referenceRange 0..* see (referenceRange) Observation.component.referenceRange
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
Observation
https://simplifier.net/hl7fhirukcorer4/ukcore-observation
0..*
Observation.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
e3dd3833-5622-4cdd-bddf-97942c58d190
Observation.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Observation.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation
Observation.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Observation.status
This MUST be populated and set to FINAL - FIXED VALUE
MUST
1..1
final
Observation.code
MUST
1..1
Observation.code.text
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
Expectations and wishes
Observation.performer
SHOULD
0..*
Observation.performer.reference
This SHOULD be populated. Where populated this MUST reference to a Practitioner resource
SHOULD
0..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
Observation.subject
MUST
0..1
Observation.subject.reference
This MUST be populated with reference to a Patient resource
MUST
0..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
Observation.encounter
MUST
0..1
Observation.encounter.reference
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
urn:uuid:8c63d621-4d86-4f57-8699-e8e22d49935d
Observation.effectiveDateTime
Follow UK Core guidance for populating this element
MAY
0..1
2023-03-08T12:01:08.4677672+00:00
Observation.note
Follow UK Core guidance for populating this element
SHOULD NOT
0..*
Observation.note.authorString
Follow UK Core guidance for populating this element
SHOULD NOT
0..1
Observation.note.text
Follow UK Core guidance for populating this element
SHOULD NOT
1..1
Resource used to communicate a healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time. This is limited to communicating consent to share information for Direct Care for this Release of BaRS A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Identifier for this record (external references) Unique identifier for this copy of the Consent Statement. This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. draft | proposed | active | rejected | inactive | entered-in-error Indicates the current state of this consent. The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid. Indicates the state of the consent. Which of the four areas this resource covers (extensible) A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. The four anticipated uses for the Consent Resource. Classification of the consent statement - for indexing/retrieval A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. A classification of the type of consents found in a consent statement. Who the consent applies to The patient/healthcare consumer to whom this consent applies. Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. When this Consent was created or indexed When this Consent was issued / created / indexed. This is not the time of the original consent, but the time that this statement was made or derived. Who is agreeing to the policy and rules consentor Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Reference( | | | | ) Custodian of the consent custodian The organization that manages the consent, and the framework within which it is executed. Source from which this consent is taken The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Reference(DocumentReference | Contract | QuestionnaireResponse | ) Policies covered by this consent The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Enforcement source for policy Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Specific policy covered by this consent The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. This element is for discoverability / documentation and does not modify or qualify the policy rules. Regulation that this consents to A reference to the specific base computable regulation or policy. Might be a unique identifier of a policy set in XACML, or other rules engine. If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Regulatory policy examples. Consent Verified by patient or family Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Has been verified Has the instruction been verified. Person who verified Who verified the instruction (Patient, Relative or other Authorized Person). Reference( | ) When consent verified Date verification was collected. Constraints to the base Consent.policyRule An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. deny | permit Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules. How a rule statement is applied, such as adding additional consent or removing consent. Timeframe for this rule The timeframe in this rule is valid. Who|what controlled by this rule (or group, by role) Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). There is no specific actor associated with the exception Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. How the actor is involved How the individual is involved in the resources content that is described in the exception. How an actor is involved in the consent considerations. Resource for the actor (or group, by role) The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Reference(Device | Group | CareTeam | | | | | ) Actions controlled by this rule Actions controlled by this Rule. Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. all actions Detailed codes for the consent action. Security Labels that define affected resources A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Security Labels from the Healthcare Privacy and Security Classification System. Context of activities covered by this rule The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. When the purpose of use tag is on the data, access request purpose of use shall not conflict. What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. e.g. Resource Type, Profile, CDA, etc. The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. The class (type) of information a consent rule covers. e.g. LOINC or SNOMED CT code, etc. in the content If this code is found in an instance, then the rule applies. Typical use of this is a Document code with class = CDA. If this code is found in an instance, then the exception applies. Timeframe for data controlled by this rule Clinical or Operational Relevant period of time that bounds the data controlled by this rule. This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data controlled by this rule The resources controlled by this rule if specific resources are referenced. all data Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. instance | related | dependents | authoredby How the resource reference is interpreted when testing consent restrictions. How a resource reference is interpreted when testing consent restrictions. The actual data reference A reference to a specific resource that defines which resources are covered by this consent. Nested Exception Rules Rules which provide exceptions to the base rule or subrules.> Consent
UKCoreConsent (Consent) I Consent Consent
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
policy.exists() or policyRule.exists()
patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()
patient.exists() or scope.coding.where(system='something' and code='research').exists().not()
patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()
patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()
id Σ 0..1 string Consent.id
meta Σ 0..1 Meta Consent.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Consent.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Consent.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Consent.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Consent.contained
extension I 0..* Extension Consent.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Consent.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Consent.identifier
hasValue() or (children().count() > id.count())
{
"system": "urn:ietf:rfc:3986",
"value": "Local eCMS identifier"
}
Mappingsid 0..1 string Consent.identifier.id
extension I 0..* Extension Consent.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Consent.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Consent.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Consent.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Consent.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Consent.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Consent.identifier.assigner
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding Consent.status
hasValue() or (children().count() > id.count())
scope Σ ?! 1..1 CodeableConceptBinding Consent.scope
hasValue() or (children().count() > id.count())
category Σ 1..* CodeableConceptBinding Consent.category
hasValue() or (children().count() > id.count())
patient Σ 0..1 Reference() Element id Consent.patient
hasValue() or (children().count() > id.count())
dateTime Σ 0..1 dateTime Consent.dateTime
hasValue() or (children().count() > id.count())
performer Σ 0..* Reference( | | | | ) Element id Consent.performer
hasValue() or (children().count() > id.count())
organization Σ 0..* Reference() Element id Consent.organization
hasValue() or (children().count() > id.count())
source[x] Σ 0..1 Consent.source[x]
hasValue() or (children().count() > id.count())
sourceAttachment Attachment Data type sourceReference Reference(DocumentReference | Contract | QuestionnaireResponse | ) Data type policy 0..* BackboneElement Consent.policy
hasValue() or (children().count() > id.count())
id 0..1 string Consent.policy.id
extension I 0..* Extension Consent.policy.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Consent.policy.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
authority I 0..1 uri Consent.policy.authority
hasValue() or (children().count() > id.count())
uri I 0..1 uri Consent.policy.uri
hasValue() or (children().count() > id.count())
policyRule Σ I 0..1 CodeableConceptBinding Consent.policyRule
hasValue() or (children().count() > id.count())
verification Σ 0..* BackboneElement Consent.verification
hasValue() or (children().count() > id.count())
id 0..1 string Consent.verification.id
extension I 0..* Extension Consent.verification.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Consent.verification.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
verified Σ 1..1 boolean Consent.verification.verified
hasValue() or (children().count() > id.count())
verifiedWith 0..1 Reference( | ) Element id Consent.verification.verifiedWith
hasValue() or (children().count() > id.count())
verificationDate 0..1 dateTime Consent.verification.verificationDate
hasValue() or (children().count() > id.count())
provision Σ 0..1 BackboneElement Consent.provision
hasValue() or (children().count() > id.count())
id 0..1 string Consent.provision.id
extension I 0..* Extension Consent.provision.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Consent.provision.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
type Σ 0..1 codeBinding Consent.provision.type
hasValue() or (children().count() > id.count())
period Σ 0..1 Period Consent.provision.period
hasValue() or (children().count() > id.count())
actor 0..* BackboneElement Consent.provision.actor
hasValue() or (children().count() > id.count())
id 0..1 string Consent.provision.actor.id
extension I 0..* Extension Consent.provision.actor.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Consent.provision.actor.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
role 1..1 CodeableConceptBinding Consent.provision.actor.role
hasValue() or (children().count() > id.count())
reference 1..1 Reference(Device | Group | CareTeam | | | | | ) Element id Consent.provision.actor.reference
hasValue() or (children().count() > id.count())
action Σ 0..* CodeableConcept Consent.provision.action
hasValue() or (children().count() > id.count())
securityLabel Σ 0..* CodingBinding Consent.provision.securityLabel
hasValue() or (children().count() > id.count())
purpose Σ 0..* CodingBinding Consent.provision.purpose
hasValue() or (children().count() > id.count())
class Σ 0..* CodingBinding Consent.provision.class
hasValue() or (children().count() > id.count())
code Σ 0..* CodeableConcept Consent.provision.code
hasValue() or (children().count() > id.count())
dataPeriod Σ 0..1 Period Consent.provision.dataPeriod
hasValue() or (children().count() > id.count())
data Σ 0..* BackboneElement Consent.provision.data
hasValue() or (children().count() > id.count())
id 0..1 string Consent.provision.data.id
extension I 0..* Extension Consent.provision.data.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Consent.provision.data.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
meaning Σ 1..1 codeBinding Consent.provision.data.meaning
hasValue() or (children().count() > id.count())
reference Σ 1..1 Reference(Resource) Consent.provision.data.reference
hasValue() or (children().count() > id.count())
provision 0..* see (provision) Consent.provision.provision
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile Cardinality
Example Value(s)
Consent
https://simplifier.net/hl7fhirukcorer4/ukcore-consent
1..*
Consent.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
e267afc4-4310-4549-b66a-5bc4db08f09b
Consent.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Consent.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent
Consent.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Consent.status
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
active
Consent.scope
MUST
1..1
Consent.scope.coding
MUST
1..1
Consent.scope.coding.system
This MUST be populated with the System namespace for the CodeSystem 'http://terminology.hl7.org/CodeSystem/consentscope' - FIXED VALUE
MUST
0..1
http://terminology.hl7.org/CodeSystem/consentscope
Consent.scope.coding.code
This MUST be populated with Code 'patient-privacy'. See CodeSystem 'http://terminology.hl7.org/CodeSystem/consentscope'. This is the only supported option for this BaRS release - FIXED VALUE
MUST
0..1
patient-privacy
Consent.Category
MUST
1..*
Consent.Category.coding
MUST
1..1
Consent.Category.coding.system
This MUST be populated with the System namespace for the CodeSystem 'https://fhir.nhs.uk/CodeSystem/consent-categories-bars' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/consent-categories-bars
Consent.Category.coding.code
This MUST be populated with Code 'DRC'. See CodeSystem 'https://fhir.nhs.uk/CodeSystem/consent-categories-bars'. This is the only supported option for this BaRS release - FIXED VALUE
MUST
0..1
DRC
Consent.Category.coding.display
This MUST be populated with Display 'Direct Care'. See CodeSystem 'https://fhir.nhs.uk/CodeSystem/consent-categories-bars'. This is the only supported option for this BaRS release - FIXED VALUE
MUST
0..1
Direct Care
Consent.patient
MUST
0..1
Consent.patient.reference
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
urn:uuid:9589fb37-87a2-48d8-968f-b371429208a8
Consent.policyRule
MUST
0..1
Consent.policyRule.coding
MUST
1..1
Consent.policyRule.coding.system
This MUST be populated with the namespace for the CodeSystem 'http://terminology.hl7.org/CodeSystem/v3-ActCode' - FIXED VALUE
MUST
0..1
http://terminology.hl7.org/CodeSystem/v3-ActCode
Consent.policyRule.coding.code
This MUST be populated with Code 'IMPLIED'. See CodeSystem 'http://terminology.hl7.org/CodeSystem/v3-ActCode'. This is the only supported option for this BaRS release - FIXED VALUE
MUST
0..1
IMPLIED
Consent.dateTime
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
26/11/2021
Payload for making a booking, using a Booking Request
This payload is used to support a booking workflow and contains all the required information for an urgent and emergency care service to create an appointment for a patient referred into their service.
> Bundle
The Bundle resource is the container for the event message
BARSBundleMessage (Bundle) | I | There are no (further) constraints on this element Element idBundle Contains a collection of resources DefinitionA container for a collection of resources.
| ||
id | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idBundle.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idBundle.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idBundle.identifier Persistent identifier for the bundle DefinitionA persistent identifier for the bundle that won't change as a bundle is copied from server to server. Persistent identity generally only matters for batches of type Document, Message, and Collection. It would not normally be populated for search and history results and servers ignore Bundle.identifier when processing batches and transactions. For Documents the .identifier SHALL be populated such that the .identifier is globally unique.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idBundle.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idBundle.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference() | There are no (further) constraints on this element Element idBundle.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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type | Σ | 1..1 | codeBindingFixed Value | Element idBundle.type document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection DefinitionIndicates the purpose of this bundle - how it is intended to be used. It's possible to use a bundle for other purposes (e.g. a document can be accepted as a transaction). This is primarily defined so that there can be specific rules for some of the bundle types. Indicates the purpose of a bundle - how it is intended to be used.
message
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timestamp | Σ | 1..1 | instant | There are no (further) constraints on this element Element idBundle.timestamp When the bundle was assembled DefinitionThe date/time that the bundle was assembled - i.e. when the resources were placed in the bundle. For many bundles, the timestamp is equal to .meta.lastUpdated, because they are not stored (e.g. search results). When a bundle is placed in a persistent store, .meta.lastUpdated will be usually be changed by the server. When the bundle is a message, a middleware agent altering the message (even if not stored) SHOULD update .meta.lastUpdated. .timestamp is used to track the original time of the Bundle, and SHOULD be populated. Usage:
The timestamp value should be greater than the lastUpdated and other timestamps in the resources in the bundle, and it should be equal or earlier than the .meta.lastUpdated on the Bundle itself.
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total | Σ I | 0..1 | unsignedInt | There are no (further) constraints on this element Element idBundle.total If search, the total number of matches DefinitionIf a set of search matches, this is the total number of entries of type 'match' across all pages in the search. It does not include search.mode = 'include' or 'outcome' entries and it does not provide a count of the number of entries in the Bundle. Only used if the bundle is a search result set. The total does not include resources such as OperationOutcome and included resources, only the total number of matching resources.
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link | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idBundle.link Links related to this Bundle DefinitionA series of links that provide context to this bundle. Both Bundle.link and Bundle.entry.link are defined to support providing additional context when Bundles are used (e.g. HATEOAS). Bundle.entry.link corresponds to links found in the HTTP header if the resource in the entry was read directly. This specification defines some specific uses of Bundle.link for searching and paging, but no specific uses for Bundle.entry.link, and no defined function in a transaction - the meaning is implementation specific.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.link.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.link.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.link.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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relation | Σ | 1..1 | string | There are no (further) constraints on this element Element idBundle.link.relation See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1 DefinitionA name which details the functional use for this link - see http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1.
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url | Σ | 1..1 | uri | There are no (further) constraints on this element Element idBundle.link.url Reference details for the link DefinitionThe reference details for the link.
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entry | Σ I | 0..* | BackboneElement | There are no (further) constraints on this element Element idBundle.entry Entry in the bundle - will have a resource or information DefinitionAn entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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link | Σ | 0..* | see (link) | There are no (further) constraints on this element Element idBundle.entry.link Links related to this entry DefinitionA series of links that provide context to this entry.
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fullUrl | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.entry.fullUrl URI for resource (Absolute URL server address or URI for UUID/OID) DefinitionThe Absolute URL for the resource. The fullUrl SHALL NOT disagree with the id in the resource - i.e. if the fullUrl is not a urn:uuid, the URL shall be version-independent URL consistent with the Resource.id. The fullUrl is a version independent reference to the resource. The fullUrl element SHALL have a value except that:
fullUrl might not be unique in the context of a resource. Note that since FHIR resources do not need to be served through the FHIR API, the fullURL might be a URN or an absolute URL that does not end with the logical id of the resource (Resource.id). However, but if the fullUrl does look like a RESTful server URL (e.g. meets the regex, then the 'id' portion of the fullUrl SHALL end with the Resource.id. Note that the fullUrl is not the same as the canonical URL - it's an absolute url for an endpoint serving the resource (these will happen to have the same value on the canonical server for the resource with the canonical URL).
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resource | Σ | 0..1 | Resource | There are no (further) constraints on this element Element idBundle.entry.resource A resource in the bundle DefinitionThe Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type. |
search | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.search Search related information DefinitionInformation about the search process that lead to the creation of this entry.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.search.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.search.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.search.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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mode | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.entry.search.mode match | include | outcome - why this is in the result set DefinitionWhy this entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process. There is only one mode. In some corner cases, a resource may be included because it is both a match and an include. In these circumstances, 'match' takes precedence. Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
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score | Σ | 0..1 | decimal | There are no (further) constraints on this element Element idBundle.entry.search.score Search ranking (between 0 and 1) DefinitionWhen searching, the server's search ranking score for the entry. Servers are not required to return a ranking score. 1 is most relevant, and 0 is least relevant. Often, search results are sorted by score, but the client may specify a different sort order. See Patient Match for the EMPI search which relates to this element.
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request | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.request Additional execution information (transaction/batch/history) DefinitionAdditional information about how this entry should be processed as part of a transaction or batch. For history, it shows how the entry was processed to create the version contained in the entry.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.request.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.request.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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method | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idBundle.entry.request.method GET | HEAD | POST | PUT | DELETE | PATCH DefinitionIn a transaction or batch, this is the HTTP action to be executed for this entry. In a history bundle, this indicates the HTTP action that occurred. HTTP verbs (in the HTTP command line). See HTTP rfc for details.
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url | Σ | 1..1 | uri | There are no (further) constraints on this element Element idBundle.entry.request.url URL for HTTP equivalent of this entry DefinitionThe URL for this entry, relative to the root (the address to which the request is posted). E.g. for a Patient Create, the method would be "POST" and the URL would be "Patient". For a Patient Update, the method would be PUT and the URL would be "Patient/[id]".
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ifNoneMatch | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifNoneMatch For managing cache currency DefinitionIf the ETag values match, return a 304 Not Modified status. See the API documentation for "Conditional Read".
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ifModifiedSince | Σ | 0..1 | instant | There are no (further) constraints on this element Element idBundle.entry.request.ifModifiedSince For managing cache currency DefinitionOnly perform the operation if the last updated date matches. See the API documentation for "Conditional Read".
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ifMatch | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifMatch For managing update contention DefinitionOnly perform the operation if the Etag value matches. For more information, see the API section "Managing Resource Contention".
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ifNoneExist | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.request.ifNoneExist For conditional creates DefinitionInstruct the server not to perform the create if a specified resource already exists. For further information, see the API documentation for "Conditional Create". This is just the query portion of the URL - what follows the "?" (not including the "?").
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response | Σ I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idBundle.entry.response Results of execution (transaction/batch/history) DefinitionIndicates the results of processing the corresponding 'request' entry in the batch or transaction being responded to or what the results of an operation where when returning history.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.response.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.entry.response.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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status | Σ | 1..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.status Status response code (text optional) DefinitionThe status code returned by processing this entry. The status SHALL start with a 3 digit HTTP code (e.g. 404) and may contain the standard HTTP description associated with the status code.
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location | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.entry.response.location The location (if the operation returns a location) DefinitionThe location header created by processing this operation, populated if the operation returns a location.
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etag | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.entry.response.etag The Etag for the resource (if relevant) DefinitionThe Etag for the resource, if the operation for the entry produced a versioned resource (see Resource Metadata and Versioning and Managing Resource Contention). Etags match the Resource.meta.versionId. The ETag has to match the version id in the header if a resource is included.
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lastModified | Σ | 0..1 | instant | There are no (further) constraints on this element Element idBundle.entry.response.lastModified Server's date time modified DefinitionThe date/time that the resource was modified on the server. This has to match the same time in the meta header (meta.lastUpdated) if a resource is included.
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outcome | Σ | 0..1 | Resource | There are no (further) constraints on this element Element idBundle.entry.response.outcome OperationOutcome with hints and warnings (for batch/transaction) DefinitionAn OperationOutcome containing hints and warnings produced as part of processing this entry in a batch or transaction. For a POST/PUT operation, this is the equivalent outcome that would be returned for prefer = operationoutcome - except that the resource is always returned whether or not the outcome is returned. This outcome is not used for error responses in batch/transaction, only for hints and warnings. In a batch operation, the error will be in Bundle.entry.response, and for transaction, there will be a single OperationOutcome instead of a bundle in the case of an error. |
signature | Σ | 0..1 | Signature | There are no (further) constraints on this element Element idBundle.signature Digital Signature DefinitionDigital Signature - base64 encoded. XML-DSig or a JWT. A Signature holds an electronic representation of a signature and its supporting context in a FHIR accessible form. The signature may either be a cryptographic type (XML DigSig or a JWS), which is able to provide non-repudiation proof, or it may be a graphical image that represents a signature or a signature process. This element allows capturing signatures on documents, messages, transactions or even search responses, to support content-authentication, non-repudiation or other business cases. This is primarily relevant where the bundle may travel through multiple hops or via other mechanisms where HTTPS non-repudiation is insufficient. The signature could be created by the "author" of the bundle or by the originating device. Requirements around inclusion of a signature, verification of signatures and treatment of signed/non-signed bundles is implementation-environment specific.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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type | Σ | 1..* | CodingBinding | There are no (further) constraints on this element Element idBundle.signature.type Indication of the reason the entity signed the object(s) DefinitionAn indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document. Examples include attesting to: authorship, correct transcription, and witness of specific event. Also known as a "Commitment Type Indication". An indication of the reason that an entity signed the object.
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when | Σ | 1..1 | instant | There are no (further) constraints on this element Element idBundle.signature.when When the signature was created DefinitionWhen the digital signature was signed. This should agree with the information in the signature.
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who | Σ | 1..1 | Reference(Device | | | | | ) | There are no (further) constraints on this element Element idBundle.signature.who Who signed DefinitionA reference to an application-usable description of the identity that signed (e.g. the signature used their private key). This should agree with the information in the signature.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.who.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idBundle.signature.who.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idBundle.signature.who.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.who.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.signature.who.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idBundle.signature.who.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.signature.who.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idBundle.signature.who.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference() | There are no (further) constraints on this element Element idBundle.signature.who.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.who.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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onBehalfOf | Σ | 0..1 | Reference(Device | | | | | ) | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf The party represented DefinitionA reference to an application-usable description of the identity that is represented by the signature. used when the signature is on behalf of a non-signer. The party that can't sign. For example a child.
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | Σ | 0..1 | uri | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. 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.
General 123456 Mappings
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period | Σ | 0..1 | Period | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use.
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assigner | Σ | 0..1 | Reference() | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idBundle.signature.onBehalfOf.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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targetFormat | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.signature.targetFormat The technical format of the signed resources DefinitionA mime type that indicates the technical format of the target resources signed by the signature. "xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here. The mime type of an attachment. Any valid mime type is allowed.
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sigFormat | 0..1 | codeBinding | There are no (further) constraints on this element Element idBundle.signature.sigFormat The technical format of the signature DefinitionA mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc. The mime type of an attachment. Any valid mime type is allowed.
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data | 0..1 | base64Binary | There are no (further) constraints on this element Element idBundle.signature.data The actual signature content (XML DigSig. JWS, picture, etc.) DefinitionThe base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty. Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.
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Data Item | Implementation Guidance | Necessity | Cadinality UKCore | Example Value(s) |
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Bundle | https://simplifier.net/nhsbookingandreferrals/barsbundlemessage | 1..1 | ||
Bundle.id | This id is generated by the originating sender of the message, retained in subsequent messages.. | MUST | 79120f41-a431-4f08-bcc5-1e67006fcae0 | |
Bundle.meta | https://www.hl7.org/fhir/resource.html#Meta | MUST | 0..1 | |
Bundle.meta.profile | This MUST be populated with the structure definition for BaRSBundleMessage : 'https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage' - FIXED VALUE | MUST | 0..1 | https://fhir.nhs.uk/StructureDefinition/BARSBundleMessage |
Bundle.meta.lastUpdated | All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent. | MUST | 0..1 | 2023-03-08T12:01:08.4677672+00:00 |
Bundle.type | This MUST be populated with 'message' - FIXED VALUE | MUST | 1..1 | message |
Bundle.timestamp | This MUST be populated with the date that the content of the message was assembled. This date is not changed by middleware engines unless they add additional data that changes the meaning of the time of the message | MUST | 0..1 | 2023-03-08T12:01:08.4677672+00:00 |
Bundle.entry(s) | Follow BaRS profile guidance for populating this element | MUST | ||
Bundle.entry.fullUrl | This MUST be populated with the unique identifier for the resource entry. Transient id relative to the bundle | MUST | 0..1 | urn:uuid:1cbdfb97-5859-48a4-8301-d54eab818d68 |
Bundle.entry.resourceType | This MUST be populated with the Resources detailed in the message definition. | MUST | 0..1 | MessageHeader,Patient, Appointment |
A resource that describes the BaRS message being exchanged between two systems. It defines the way that the Appointment bundle should be processed when it is being consumed by a receiver A resource that describes a message that is exchanged between systems The header for a message exchange that is either requesting or responding to an action. The reference(s) that are the subject of the action as well as other information related to the action are typically transmitted in a bundle in which the MessageHeader resource instance is the first resource in the bundle. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) An extension to carry a specific instruction for receivers of the message. extensions, user content An extension to carry a specific instruction for receivers of the message. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MessageHeaderInstruction Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Code for the event this message represents or link to event definition Code that identifies the event this message represents and connects it with its definition. Events defined as part of the FHIR specification have the system value "http://terminology.hl7.org/CodeSystem/message-events". Alternatively uri to the EventDefinition. Drives the behavior associated with this message. The time of the event will be found in the focus resource. The time of the message will be found in Bundle.timestamp. Message event Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) This will be a set of fixed values that are used to trigger use case specific processing when the bundle is received (refer to guidance for definitions etc..) Message destination application(s) The destination application which the message is intended for. Indicates where message is to be sent for routing purposes. Allows verification of "am I the intended recipient". There SHOULD be at least one destination, but in some circumstances, the source system is unaware of any particular destination system. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Name of system Human-readable name for the target system. May be used for routing of response and/or to support audit. Particular delivery destination within the destination Identifies the target end system in situations where the initial message transmission is to an intermediary system. Supports multi-hop routing. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Actual destination address or id Indicates where the message should be routed to. Identifies where to route the message. The id may be a non-resolvable URI for systems that do not use standard network-based addresses. Intended "real-world" recipient for the data Allows data conveyed by a message to be addressed to a particular person or department when routing to a specific application isn't sufficient. Allows routing beyond just the application level. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Real world sender of the message Identifies the sending system to allow the use of a trust relationship. Allows routing beyond just the application level. Use case is for where a (trusted) sending system is responsible for multiple organizations, and therefore cannot differentiate based on source endpoint / authentication alone. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Reference to the Requester Organisation Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The source of the data entry The person or device that performed the data entry leading to this message. When there is more than one candidate, pick the most proximal to the message. Can provide other enterers in extensions. Need to know for audit/traceback requirements and possibly for authorization. Usually only for the request but can be used in a response. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The source of the decision The logical author of the message - the person or device that decided the described event should happen. When there is more than one candidate, pick the most proximal to the MessageHeader. Can provide other authors in extensions. Need to know for audit/traceback requirements and possibly for authorization. Usually only for the request but can be used in a response. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Message source application The source application from which this message originated. Allows replies, supports audit. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Optional Extensions Element extensions, user content Optional Extension Element - found in all resources. 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. Extension(Complex) https://fhir.nhs.uk/StructureDefinition/CDSSExtension Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Name of system Human-readable name for the source system. May be used to support audit. EMS Supplier company/ product name Name of software running the system May include configuration or other information useful in debugging. Supports audit and possibly interface engine behavior. Version of software running Can convey versions of multiple systems in situations where a message passes through multiple hands. Supports audit and possibly interface engine behavior. EMS software version Human contact for problems An e-mail, phone, website or other contact point to use to resolve issues with message communications. Allows escalation of technical issues. Actual message source address or id Identifies the routing target to send acknowledgements to. Identifies where to send responses, may influence security permissions. The uri of the Requester’s endpoint Final responsibility for event The person or organization that accepts overall responsibility for the contents of the message. The implication is that the message event happened under the policies of the responsible party. Need to know for audit/traceback requirements and possibly for authorization. Usually only for the request but can be used in a response. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Cause of event Coded indication of the cause for the event - indicates a reason for the occurrence of the event that is a focus of this message. Need to be able to track why resources are being changed and report in the audit log/history of the resource. May affect authorization. Reason for event occurrence. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Code defined by a terminology system A reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Identity of the terminology system The identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. BARS Event lifecycle "new", "update" Version of the system - if relevant The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. Symbol in syntax defined by the system A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Representation defined by the system A representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. If this coding was chosen directly by the user Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. Plain text representation of the concept A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings. If this is a reply to prior message Information about the message that this message is a response to. Only present if this message is a response. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Id of original message The MessageHeader.id of the message to which this message is a response. Allows receiver to know what message is being responded to. ok | transient-error | fatal-error Code that identifies the type of response to the message - whether it was successful or not, and whether it should be resent or not. Allows the sender of the acknowledge message to know if the request was successful or if action is needed. This is a generic response to the request message. Specific data for the response will be found in MessageHeader.focus. The kind of response to a message. Specific list of hints/warnings/errors Full details of any issues found in the message. Allows the sender of the message to determine what the specific issues are. This SHALL be contained in the bundle. If any of the issues are errors, the response code SHALL be an error. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The actual content of the message The actual data of the message - a reference to the root/focus class of the event. Every message event is about actual data, a single resource, that is identified in the definition of the event, and perhaps some or all linked resources. The data is defined where the transaction type is defined. The transaction data is always included in the bundle that is the full message. Only the root resource is specified. The resources it references should be contained in the bundle but are not also listed here. Multiple repetitions are allowed to cater for merges and other situations with multiple focal targets. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. This MUST reference the UKCore-ServiceRequest resource. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Link to the definition for this message Permanent link to the MessageDefinition for this message. Allows sender to define the expected contents of the message.
> Message Header
BARSMessageHeaderBookingRequest (MessageHeader) I MessageHeader
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string MessageHeader.id
meta Σ 0..1 Meta MessageHeader.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri MessageHeader.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding MessageHeader.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative MessageHeader.text
hasValue() or (children().count() > id.count())
contained 0..* Resource MessageHeader.contained
extension I 0..* Extension MessageHeader.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
messageHeaderInstruction I 0..* Extension(Coding) MessageHeader.extension:messageHeaderInstruction
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension MessageHeader.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
event[x] Σ 1..1 Binding MessageHeader.event[x]
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.event[x].id
extension I 0..* Extension MessageHeader.event[x].extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Fixed Value MessageHeader.event[x].system
https://fhir.nhs.uk/CodeSystem/message-events-bars
code 1.. Fixed Value MessageHeader.event[x].code
booking-request
eventCoding Coding eventUri uri destination Σ 1..* BackboneElement MessageHeader.destination
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.id
extension I 0..* Extension MessageHeader.destination.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension MessageHeader.destination.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
name Σ 0..1 string MessageHeader.destination.name
hasValue() or (children().count() > id.count())
target Σ 0..1 Reference() MessageHeader.destination.target
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.target.id
extension I 0..* Extension MessageHeader.destination.target.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.destination.target.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.destination.target.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.destination.target.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.target.identifier.id
extension I 0..* Extension MessageHeader.destination.target.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.destination.target.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.destination.target.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.destination.target.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.destination.target.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.destination.target.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.destination.target.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.destination.target.display
hasValue() or (children().count() > id.count())
endpoint Σ 1..1 url MessageHeader.destination.endpoint
hasValue() or (children().count() > id.count())
receiver Σ 0..1 Reference( | | ) MessageHeader.destination.receiver
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.receiver.id
extension I 0..* Extension MessageHeader.destination.receiver.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 1..1 string MessageHeader.destination.receiver.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.destination.receiver.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.destination.receiver.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.destination.receiver.identifier.id
extension I 0..* Extension MessageHeader.destination.receiver.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.destination.receiver.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.destination.receiver.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.destination.receiver.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.destination.receiver.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.destination.receiver.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.destination.receiver.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.destination.receiver.display
hasValue() or (children().count() > id.count())
sender Σ 0..1 Reference( | | ) MessageHeader.sender
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.sender.id
extension I 0..* Extension MessageHeader.sender.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 1..1 string MessageHeader.sender.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.sender.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.sender.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.sender.identifier.id
extension I 0..* Extension MessageHeader.sender.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.sender.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.sender.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.sender.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.sender.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.sender.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.sender.identifier.assigner
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.sender.identifier.assigner.id
extension I 0..* Extension MessageHeader.sender.identifier.assigner.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 1..1 string Element id MessageHeader.sender.identifier.assigner.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.sender.identifier.assigner.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.sender.identifier.assigner.identifier
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.sender.identifier.assigner.display
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.sender.display
hasValue() or (children().count() > id.count())
enterer Σ 0..1 Reference( | ) MessageHeader.enterer
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.enterer.id
extension I 0..* Extension MessageHeader.enterer.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.enterer.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.enterer.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.enterer.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.enterer.identifier.id
extension I 0..* Extension MessageHeader.enterer.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.enterer.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.enterer.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.enterer.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.enterer.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.enterer.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.enterer.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.enterer.display
hasValue() or (children().count() > id.count())
author Σ 0..1 Reference( | ) MessageHeader.author
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.author.id
extension I 0..* Extension MessageHeader.author.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.author.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.author.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.author.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.author.identifier.id
extension I 0..* Extension MessageHeader.author.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.author.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.author.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.author.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.author.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.author.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.author.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.author.display
hasValue() or (children().count() > id.count())
source Σ 1..1 BackboneElement MessageHeader.source
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.source.id
extension I 0..* Extension Element id MessageHeader.source.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
myExtension I 0..* Extension(Complex) Element id MessageHeader.source.extension:myExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension MessageHeader.source.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
name Σ 0..1 string Element id MessageHeader.source.name
hasValue() or (children().count() > id.count())
software Σ 0..1 string MessageHeader.source.software
hasValue() or (children().count() > id.count())
version Σ 0..1 string Element id MessageHeader.source.version
hasValue() or (children().count() > id.count())
contact Σ 0..1 ContactPoint MessageHeader.source.contact
hasValue() or (children().count() > id.count())
endpoint Σ 1..1 url Element id MessageHeader.source.endpoint
hasValue() or (children().count() > id.count())
responsible Σ 0..1 Reference( | | ) MessageHeader.responsible
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.responsible.id
extension I 0..* Extension MessageHeader.responsible.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.responsible.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.responsible.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.responsible.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.responsible.identifier.id
extension I 0..* Extension MessageHeader.responsible.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.responsible.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.responsible.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.responsible.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.responsible.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.responsible.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.responsible.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.responsible.display
hasValue() or (children().count() > id.count())
reason Σ 1..1 CodeableConcept MessageHeader.reason
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.reason.id
extension I 0..* Extension MessageHeader.reason.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
coding Σ 0..* Coding MessageHeader.reason.coding
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.reason.coding.id
extension I 0..* Extension MessageHeader.reason.coding.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ 0..1 uriFixed Value Element id MessageHeader.reason.coding.system
hasValue() or (children().count() > id.count())
https://fhir.nhs.uk/CodeSystem/message-reason-bars
version Σ 0..1 string MessageHeader.reason.coding.version
hasValue() or (children().count() > id.count())
code Σ 0..1 code MessageHeader.reason.coding.code
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.reason.coding.display
hasValue() or (children().count() > id.count())
userSelected Σ 0..1 boolean MessageHeader.reason.coding.userSelected
hasValue() or (children().count() > id.count())
text Σ 0..1 string MessageHeader.reason.text
hasValue() or (children().count() > id.count())
response Σ 0..1 BackboneElement MessageHeader.response
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.response.id
extension I 0..* Extension MessageHeader.response.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension MessageHeader.response.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 1..1 id MessageHeader.response.identifier
hasValue() or (children().count() > id.count())
code Σ 1..1 codeBinding MessageHeader.response.code
hasValue() or (children().count() > id.count())
details Σ 0..1 Reference() MessageHeader.response.details
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.response.details.id
extension I 0..* Extension MessageHeader.response.details.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string MessageHeader.response.details.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.response.details.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.response.details.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.response.details.identifier.id
extension I 0..* Extension MessageHeader.response.details.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.response.details.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.response.details.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.response.details.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.response.details.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.response.details.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.response.details.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.response.details.display
hasValue() or (children().count() > id.count())
focus Σ 0..* Reference(Resource) MessageHeader.focus
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.focus.id
extension I 0..* Extension MessageHeader.focus.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 1..1 string Element id MessageHeader.focus.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding MessageHeader.focus.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier MessageHeader.focus.identifier
hasValue() or (children().count() > id.count())
id 0..1 string MessageHeader.focus.identifier.id
extension I 0..* Extension MessageHeader.focus.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding MessageHeader.focus.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding MessageHeader.focus.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri MessageHeader.focus.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string MessageHeader.focus.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period MessageHeader.focus.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() MessageHeader.focus.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string MessageHeader.focus.display
hasValue() or (children().count() > id.count())
definition Σ 0..1 canonical(MessageDefinition) MessageHeader.definition
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Cadinality UKCore
Example Value(s)
MessageHeader
https://simplifier.net/nhsbookingandreferrals/barsmessageheaderbookingrequest-duplicate-2
1..1
MessageHeader.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
0..1
MessageHeader.meta.profile
This MUST be populated with the structure definition forBARSMessageHeader-booking-request
MUST
0..1
https://fhir.nhs.uk/StructureDefinition/BARSMessageHeader-booking-request
MessageHeader.meta.lastUpdated
All resources MUST include 'lastUpdated' value, under the meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates to resources, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
0..1
2023-03-08T12:01:08.4677672+00:00
MessageHeader.extension
This MUST be populated with details of the Clinical Decision Support System used
MUST
0..1
MessageHeader.extension.url
This MUST be populated with 'https://fhir.nhs.uk/StructureDefinition/CDSSExtension' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/StructureDefinition/CDSSExtension
MessageHeader.extension.extension
MUST
0..1
MessageHeader.extension.extension.url
This MUST be populated with the pre-defined Clinical Decision Support System software url - FIXED VALUE
MUST
0..1
requesterCDSSSoftware
MessageHeader.extension.extension.valueString
This MUST be populated with the Clinical Decision Support System software name e.g. Pathways
MUST
0..1
Pathways
MessageHeader.extension.extension
MUST
0..1
MessageHeader.extension.extension.url
This MUST be populated with the pre-defined Clinical Decision Support System software Version url - FIXED VALUE
MUST
0..1
requesterCDSSVersion
MessageHeader.extension.extension.valueString
This MUST be populated with the Clinical Decision Support System software Version name e.g. 30.2.0
MUST
0..1
30.2.0
MessageHeader.eventcoding
MUST
1..1
MessageHeader.eventcoding.system
This MUST be populated with CodeSystem 'https://fhir.nhs.uk/CodeSystem/message-events-bars' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/message-events-bars
MessageHeader.eventcoding.code
The status MUST be populated with 'booking-request'. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-events-bars' - FIXED VALUE
MUST
0..1
booking-request
MessageHeader.destination
MUST
0..1
MessageHeader.destination.receiver
MUST
0..1
MessageHeader.destination.receiver.reference
This MUST be populated with the full url to the Receiving Organisation resource.
MUST
0..1
urn:uuid:10397afd-479c-42ea-9d5d-e4024481e0f8
MessageHeader.destination.endpoint
This MUST be populated with the system and Service ID separated by a pipe. for example https://fhir.nhs.uk/id/dos-service-id\|11111111, this is to ensure the receiver knows the intended destination.
MUST
1..1
https://fhir.nhs.uk/id/dos-service-id\|1122334455
MessageHeader.sender
MUST
0..1
MessageHeader.sender.reference
This MUST be populated. Follow BaRS profile guidance for populating this element
MUST
0..1
urn:uuid:07939a0c-2854-46ff-9282-ad906bc93679
MessageHeader.source
MUST
1..1
MessageHeader.source.name
This MUST be populated with the sending system supplier name
MUST
0..1
Patient Access System
MessageHeader.source.software
This SHOULD be populated with the sending software application name
SHOULD
0..1
Supplier Software
MessageHeader.source.version
This SHOULD be populated with the sending software version
SHOULD
0..1
V1.0.0
MessageHeader.source.contact
SHOULD
0..1
MessageHeader.source.contact.system
This SHOULD be populated with the Contact Type - phone | fax | email | pager | url | sms | other
SHOULD
0..1
phone
MessageHeader.source.contact.value
This SHOULD be populated with the Contact Type value
SHOULD
0..1
+44 (0123) 123 4567
MessageHeader.source.endpoint
This MUST be populated with the system and Service ID separated by a pipe. for example https://fhir.nhs.uk/id/dos-service-id\|11111111, this is to ensure the receiver knows where any response messages SHOULD be addressed.
MUST
1..1
https://fhir.nhs.uk/id/dos-service-id\\|5566778899
MessageHeader.reason
MUST
0..1
MessageHeader.reason.coding
MUST
0..1
MessageHeader.reason.coding.system
This MUST be populated with 'https://fhir.nhs.uk/CodeSystem/message-reason-bars' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/message-reason-bars
MessageHeader.reason.coding.code
This MUST be populated with 'new' in a new message and 'update' for an update. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/message-events-bars'
MUST
0..1
new
MessageHeader.reason.coding.display
This SHOULD be populated with 'new' in a new message and 'update' for an update.
SHOULD
0..1
New
MessageHeader.focus
MUST
0..*
MessageHeader.focus.reference
This MUST be populated with a reference to the Appointment
MUST
0..1
urn:uuid:236bb75d-90ef-461f-b71e-fde7f899802c
MessageHeader.definition
This MUST be populated with the MessageDefinition the bundle is based on. This will be used for validation. Value - https://fhir.nhs.uk/MessageDefinition/bars-message-booking-request
MUST
0..1
https://fhir.nhs.uk/MessageDefinition/bars-message-booking-request
This resource will be used to communicate information about an Appointment and is the focus of the Booking interation. A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s) A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s). Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) An extension to record the organisation booking the appointment extensions, user content An extension to record the organisation booking the appointment. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BookingOrganization An extension to record the delivery channel of a scheduled Appointment extensions, user content An extension to record the delivery channel of a scheduled Appointment. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeliveryChannel Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. External Ids for this item This records identifiers associated with this appointment concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist The overall status of the Appointment. Each of the participants has their own participation status which indicates their involvement in the process, however this status indicates the shared status. If the Appointment's status is "cancelled" then all participants are expected to have their calendars released for the appointment period, and as such any Slots that were marked as BUSY can be re-set to FREE. This element is labeled as a modifier because the status contains the code entered-in-error that mark the Appointment as not currently valid. The free/busy status of an appointment. The coded reason for the appointment being cancelled The coded reason for the appointment being cancelled. This is often used in reporting/billing/futher processing to determine if further actions are required, or specific fees apply. AppointmentCancellationReason (example) A broad categorization of the service that is to be performed during this appointment A broad categorization of the service that is to be performed during this appointment. The specific service that is to be performed during this appointment The specific service that is to be performed during this appointment. For a provider to provider appointment the code "FOLLOWUP" may be appropriate, as this is expected to be discussing some patient that was seen in the past. The specialty of a practitioner that would be required to perform the service requested in this appointment The specialty of a practitioner that would be required to perform the service requested in this appointment. PracticeSettingCodeValueSet (preferred) The style of appointment or patient that has been booked in the slot (not service type) The style of appointment or patient that has been booked in the slot (not service type). A set of codes that define an appointment reason. Coded reason this appointment is scheduled The coded reason that this appointment is being scheduled. This is more clinical than administrative. The Reason for the appointment to take place. Reason the appointment is to take place (resource) Reason the appointment has been scheduled to take place, as specified using information from another resource. When the patient arrives and the encounter begins it may be used as the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure. Reference( | | | ImmunizationRecommendation) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Used to make informed decisions if needing to re-prioritize The priority of the appointment. Can be used to make informed decisions if needing to re-prioritize appointments. (The iCal Standard specifies 0 as undefined, 1 as highest, 9 as lowest priority). Seeking implementer feedback on this property and how interoperable it is. Using an extension to record a CodeableConcept for named values may be tested at a future connectathon. Shown on a subject line in a meeting request, or appointment list The brief description of the appointment as would be shown on a subject line in a meeting request, or appointment list. Detailed or expanded information should be put in the comment field. Additional information to support the appointment Additional information to support the appointment provided when making the appointment. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. When appointment is to take place Date/Time that the appointment is to take place. When appointment is to conclude Date/Time that the appointment is to conclude. Can be less than start/end (e.g. estimate) Number of minutes that the appointment is to take. This can be less than the duration between the start and end times. For example, where the actual time of appointment is only an estimate or if a 30 minute appointment is being requested, but any time would work. Also, if there is, for example, a planned 15 minute break in the middle of a long appointment, the duration may be 15 minutes less than the difference between the start and end. The slots that this appointment is filling The slots from the participants' schedules that will be filled by the appointment. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The date that this appointment was initially created The date that this appointment was initially created. This could be different to the meta.lastModified value on the initial entry, as this could have been before the resource was created on the FHIR server, and should remain unchanged over the lifespan of the appointment. This property is required for many use cases where the age of an appointment is considered in processing workflows for scheduling and billing of appointments. Additional comments Additional comments about the appointment. Additional text to aid in facilitating the appointment. For instance, a comment might be, "patient should proceed immediately to infusion room upon arrival" Where this is a planned appointment and the start/end dates are not set then this field can be used to provide additional guidance on the details of the appointment request, including any restrictions on when to book it. Detailed information and instructions for the patient While Appointment.comment contains information for internal use, Appointment.patientInstructions is used to capture patient facing information about the Appointment (e.g. please bring your referral or fast from 8pm night before). The service request this appointment is allocated to assess incomingReferral The service request this appointment is allocated to assess (e.g. incoming referral or procedure request). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Participants involved in appointment List of participants involved in the appointment. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Role of participant in the appointment Role of participant in the appointment. The role of the participant can be used to declare what the actor will be doing in the scope of this appointment. If the actor is not specified, then it is expected that the actor will be filled in at a later stage of planning. This value SHALL be the same when creating an AppointmentResponse so that they can be matched, and subsequently update the Appointment. Role of participant in encounter. Person, Location/HealthcareService or Device A Person, Location/HealthcareService or Device that is participating in the appointment. Reference( | | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. required | optional | information-only Whether this participant is required to be present at the meeting. This covers a use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present. Is the Participant required to attend the appointment. accepted | declined | tentative | needs-action Participation status of the actor. The Participation status of an appointment. Participation period of the actor Participation period of the actor. Potential date/time interval(s) requested to allocate the appointment within A set of date ranges (potentially including times) that the appointment is preferred to be scheduled within. The duration (usually in minutes) could also be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time. However, in other situations the duration may be calculated by the scheduling system. This does not introduce a capacity for recurring appointments.
> Appointment
UKCoreAppointment (Appointment) I Appointment Appointment
start.exists() = end.exists()
(start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Appointment.id
meta Σ 0..1 Meta Appointment.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Appointment.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Appointment.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Appointment.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Appointment.contained
extension I 0..* Extension Element id Appointment.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
bookingOrganization I 0..1 Extension(Reference()) Element id Appointment.extension:bookingOrganization
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
deliveryChannel I 0..1 Extension(code) Element id Appointment.extension:deliveryChannel
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Appointment.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Appointment.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.identifier.id
extension I 0..* Extension Appointment.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Appointment.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Appointment.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Appointment.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Appointment.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Appointment.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Appointment.identifier.assigner
hasValue() or (children().count() > id.count())
status Σ ?! 1..1 codeBinding Appointment.status
hasValue() or (children().count() > id.count())
cancelationReason Σ 0..1 CodeableConcept Appointment.cancelationReason
hasValue() or (children().count() > id.count())
serviceCategory Σ 0..* CodeableConcept Appointment.serviceCategory
hasValue() or (children().count() > id.count())
serviceType Σ 0..* CodeableConcept Appointment.serviceType
hasValue() or (children().count() > id.count())
specialty Σ 0..* CodeableConceptBinding Appointment.specialty
hasValue() or (children().count() > id.count())
appointmentType Σ 0..1 CodeableConceptBinding Element id Appointment.appointmentType
hasValue() or (children().count() > id.count())
reasonCode Σ 0..* CodeableConceptBinding Appointment.reasonCode
hasValue() or (children().count() > id.count())
reasonReference 0..* Reference( | | | ImmunizationRecommendation) Element id Appointment.reasonReference
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.reasonReference.id
extension I 0..* Extension Appointment.reasonReference.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Appointment.reasonReference.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Appointment.reasonReference.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Appointment.reasonReference.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.reasonReference.identifier.id
extension I 0..* Extension Appointment.reasonReference.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Appointment.reasonReference.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Appointment.reasonReference.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Appointment.reasonReference.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Appointment.reasonReference.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Appointment.reasonReference.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Appointment.reasonReference.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Appointment.reasonReference.display
hasValue() or (children().count() > id.count())
priority 0..1 unsignedInt Appointment.priority
hasValue() or (children().count() > id.count())
description 0..1 string Appointment.description
hasValue() or (children().count() > id.count())
supportingInformation 0..* Reference(Resource) Appointment.supportingInformation
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.supportingInformation.id
extension I 0..* Extension Appointment.supportingInformation.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Appointment.supportingInformation.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Appointment.supportingInformation.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Appointment.supportingInformation.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.supportingInformation.identifier.id
extension I 0..* Extension Appointment.supportingInformation.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Appointment.supportingInformation.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Appointment.supportingInformation.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Appointment.supportingInformation.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Appointment.supportingInformation.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Appointment.supportingInformation.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Appointment.supportingInformation.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Appointment.supportingInformation.display
hasValue() or (children().count() > id.count())
start Σ 0..1 instant Appointment.start
hasValue() or (children().count() > id.count())
end Σ 0..1 instant Appointment.end
hasValue() or (children().count() > id.count())
minutesDuration 0..1 positiveInt Appointment.minutesDuration
hasValue() or (children().count() > id.count())
slot 0..* Reference() Element id Appointment.slot
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.slot.id
extension I 0..* Extension Appointment.slot.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Appointment.slot.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Appointment.slot.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Appointment.slot.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.slot.identifier.id
extension I 0..* Extension Appointment.slot.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Appointment.slot.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Appointment.slot.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Appointment.slot.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Appointment.slot.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Appointment.slot.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Appointment.slot.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Appointment.slot.display
hasValue() or (children().count() > id.count())
created 0..1 dateTime Appointment.created
hasValue() or (children().count() > id.count())
comment 0..1 string Appointment.comment
hasValue() or (children().count() > id.count())
patientInstruction 0..1 string Appointment.patientInstruction
hasValue() or (children().count() > id.count())
basedOn 0..* Reference() Element id Appointment.basedOn
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.basedOn.id
extension I 0..* Extension Appointment.basedOn.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Appointment.basedOn.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Appointment.basedOn.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Appointment.basedOn.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.basedOn.identifier.id
extension I 0..* Extension Appointment.basedOn.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Appointment.basedOn.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Appointment.basedOn.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Appointment.basedOn.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Appointment.basedOn.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Appointment.basedOn.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Appointment.basedOn.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Appointment.basedOn.display
hasValue() or (children().count() > id.count())
participant I 1..* BackboneElement Appointment.participant
type.exists() or actor.exists()
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.participant.id
extension I 0..* Extension Appointment.participant.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Appointment.participant.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
type Σ 0..* CodeableConceptBinding Appointment.participant.type
hasValue() or (children().count() > id.count())
actor Σ 0..1 Reference( | | | | | | ) Element id Appointment.participant.actor
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.participant.actor.id
extension I 0..* Extension Appointment.participant.actor.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Appointment.participant.actor.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Appointment.participant.actor.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Appointment.participant.actor.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Appointment.participant.actor.identifier.id
extension I 0..* Extension Appointment.participant.actor.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Appointment.participant.actor.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Appointment.participant.actor.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Appointment.participant.actor.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Appointment.participant.actor.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Appointment.participant.actor.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Appointment.participant.actor.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Appointment.participant.actor.display
hasValue() or (children().count() > id.count())
required Σ 0..1 codeBinding Appointment.participant.required
hasValue() or (children().count() > id.count())
status Σ 1..1 codeBinding Appointment.participant.status
hasValue() or (children().count() > id.count())
period 0..1 Period Appointment.participant.period
hasValue() or (children().count() > id.count())
requestedPeriod 0..* Period Appointment.requestedPeriod
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Profile cardinality
Example Value(s)
Appointment
https://simplifier.net/hl7fhirukcorer4/ukcore-appointment
1..1
Appointment.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
0..1
3713c8fc-dbcf-4f90-bacf-89d99e434e9b
Appointment.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Appointment.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Appointment
Appointment.meta.lastupdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Appointment.status
This MUST be populated with 'booked' or 'cancelled'
MUST
1..1
booked
Appointent.serviceCategory
Appointent.serviceCategory.coding
BaRS Use Case
MUST
0..*
Appointent.serviceCategory.coding.system
This MUST be populated with CodeSystem 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars' - FIXED VALUE
MUST
0..1
https://fhir.nhs.uk/CodeSystem/usecases-categories-bars
Appointent.serviceCategory.coding.code
This MUST be populated with Code for the use-case. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars'
MUST
0..1
A1T1
Appointent.serviceCategory.coding.display
This MUST be populated with Display for the use-case. See CodeSystem: 'https://fhir.nhs.uk/CodeSystem/usecases-categories-bars'
MUST
0..1
111 - ED
Appointment.description
This SHOULD be populated. It is the human readable description of the booking
SHOULD
0..1
Reason for calling
Appointment.start
This MUST be populated with the Start time of the booking
MUST
0..1
2021-10-12T12:30:00+00:00
Appointment.end
This MUST be populated with the End time of the booking
MUST
0..1
2021-10-12T12:30:00+00:00
Appointment.slot
MUST
0..*
Appointment.slot.reference
This MUST be populated with the local logical bundle reference to the Slot resource
MUST
0..1
urn:uuid:c3f6145e-1a26-4345-b3f2-dccbcba62049
Appointment.created
This MUST only be populated with the date/time the booking was generated by the Receiver in the synchronous HTTP response.
MUST
0..1
2021-10-11T15:01:30+00:00"
Appointment.basedOn
This MAY be populated. When the Service Request is made before the booking in the workflow this MUST be populated.
MAY
0..*
Appointment.basedOn.reference
This MAY be populated. This is MUST be the relative reference to the Service Request when referral is made before booking in the workflow
MAY
0..1
ServiceRequest/236bb75d-90ef-461f-b71e-fde7f899802c
Appointment.participant
MUST
1..1
Appointment.participant.actor
This MUST be populated with reference to the patient
MUST
0..1
Appointment.participant.actor.reference
This MUST be populated with the local logical bundle reference to the Patient resource
MUST
0..1
urn:uuid:3a62607b-df65-4932-940c-14262787f62d
Appointment.participant.actor.status
This MUST be populated with 'accepted' - FIXED VALUE
MUST
1..1
accepted
This resource will be used to communicate information about the slot. The Slot resource retrieved via the GET /Slot request and MUST be returned how it was received A slot of time on a schedule that may be available for booking appointments A slot of time on a schedule that may be available for booking appointments. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) An extension to record the delivery channel of a scheduled Appointment extensions, user content An extension to record the delivery channel of a scheduled Appointment. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeliveryChannel Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. External Ids for this item External Ids for this item. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. A broad categorization of the service that is to be performed during this appointment A broad categorization of the service that is to be performed during this appointment. The type of appointments that can be booked into this slot (ideally this would be an identifiable service - which is at a location, rather than the location itself). If provided then this overrides the value provided on the availability resource The type of appointments that can be booked into this slot (ideally this would be an identifiable service - which is at a location, rather than the location itself). If provided then this overrides the value provided on the availability resource. The specialty of a practitioner that would be required to perform the service requested in this appointment The specialty of a practitioner that would be required to perform the service requested in this appointment. Additional details about where the content was created (e.g. clinical specialty). The style of appointment or patient that may be booked in the slot (not service type) The style of appointment or patient that may be booked in the slot (not service type). The schedule resource that this slot defines an interval of status information The schedule resource that this slot defines an interval of status information. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. busy | free | busy-unavailable | busy-tentative | entered-in-error busy | free | busy-unavailable | busy-tentative | entered-in-error. The free/busy status of the slot. Date/Time that the slot is to begin Date/Time that the slot is to begin. Date/Time that the slot is to conclude Date/Time that the slot is to conclude. This slot has already been overbooked, appointments are unlikely to be accepted for this time This slot has already been overbooked, appointments are unlikely to be accepted for this time. If overbooked is missing, systems may assume that there are still appointments available Comments on the slot to describe any extended information. Such as custom constraints on the slot Comments on the slot to describe any extended information. Such as custom constraints on the slot.> Slot
UKCoreSlot (Slot) I Slot Slot
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Slot.id
meta Σ 0..1 Meta Slot.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Slot.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Slot.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Slot.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Slot.contained
extension I 0..* Extension Element id Slot.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
deliveryChannel I 0..1 Extension(code) Element id Slot.extension:deliveryChannel
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Slot.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Slot.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Slot.identifier.id
extension I 0..* Extension Slot.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Slot.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Slot.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Slot.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Slot.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Slot.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Slot.identifier.assigner
hasValue() or (children().count() > id.count())
serviceCategory Σ 0..* CodeableConcept Slot.serviceCategory
hasValue() or (children().count() > id.count())
serviceType Σ 0..* CodeableConcept Slot.serviceType
hasValue() or (children().count() > id.count())
specialty Σ 0..* CodeableConceptBinding Slot.specialty
hasValue() or (children().count() > id.count())
appointmentType Σ 0..1 CodeableConceptBinding Slot.appointmentType
hasValue() or (children().count() > id.count())
schedule Σ 1..1 Reference() Element id Slot.schedule
hasValue() or (children().count() > id.count())
id 0..1 string Slot.schedule.id
extension I 0..* Extension Slot.schedule.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Slot.schedule.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Slot.schedule.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Slot.schedule.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Slot.schedule.identifier.id
extension I 0..* Extension Slot.schedule.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Slot.schedule.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Slot.schedule.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Slot.schedule.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Slot.schedule.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Slot.schedule.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Slot.schedule.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Slot.schedule.display
hasValue() or (children().count() > id.count())
status Σ 1..1 codeBinding Slot.status
hasValue() or (children().count() > id.count())
start Σ 1..1 instant Slot.start
hasValue() or (children().count() > id.count())
end Σ 1..1 instant Slot.end
hasValue() or (children().count() > id.count())
overbooked 0..1 boolean Slot.overbooked
hasValue() or (children().count() > id.count())
comment 0..1 string Slot.comment
hasValue() or (children().count() > id.count())
This resource will be used to communicate information about the schedule. The Schedule resource retrieved via the GET /Slot request and MUST be returned how it was received A container for slots of time that may be available for booking appointments Availability A container for slots of time that may be available for booking appointments. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. External Ids for this item External Ids for this item. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this schedule is in active use Whether this schedule record is in active use or should not be used (such as was entered in error). This element is labeled as a modifier because it may be used to mark that the resource was created in error. This resource is generally assumed to be active if no value is provided for the active element High-level category A broad categorization of the service that is to be performed during this appointment. Specific service The specific service that is to be performed during this appointment. Type of specialty needed The specialty of a practitioner that would be required to perform the service requested in this appointment. Additional details about where the content was created (e.g. clinical specialty). Resource(s) that availability information is being provided for Slots that reference this schedule resource provide the availability details to these referenced resource(s). The capacity to support multiple referenced resource types should be used in cases where the specific resources themselves cannot be scheduled without the other, and thus only make sense to the system exposing them as a group. Common examples of this are where the combination of a practitioner and a room (Location) are always required by a system. Reference( | | | | | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Period of time covered by schedule The period of time that the slots that reference this Schedule resource cover (even if none exist). These cover the amount of time that an organization's planning horizon; the interval for which they are currently accepting appointments. This does not define a "template" for planning outside these dates. Comments on availability Comments on the availability to describe any extended information. Such as custom constraints on the slots that may be associated.
> Schedule
UKCoreSchedule (Schedule) I Schedule Schedule
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Schedule.id
meta Σ 0..1 Meta Schedule.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Schedule.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Schedule.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Schedule.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Schedule.contained
extension I 0..* Extension Schedule.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Schedule.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Schedule.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Schedule.identifier.id
extension I 0..* Extension Schedule.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Schedule.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Schedule.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Schedule.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Schedule.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Schedule.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Schedule.identifier.assigner
hasValue() or (children().count() > id.count())
active Σ ?! 0..1 boolean Schedule.active
hasValue() or (children().count() > id.count())
serviceCategory Σ 0..* CodeableConcept Schedule.serviceCategory
hasValue() or (children().count() > id.count())
serviceType Σ 0..* CodeableConcept Schedule.serviceType
hasValue() or (children().count() > id.count())
specialty Σ 0..* CodeableConceptBinding Schedule.specialty
hasValue() or (children().count() > id.count())
actor Σ 1..* Reference( | | | | | | ) Element id Schedule.actor
hasValue() or (children().count() > id.count())
id 0..1 string Schedule.actor.id
extension I 0..* Extension Schedule.actor.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Schedule.actor.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Schedule.actor.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Schedule.actor.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Schedule.actor.identifier.id
extension I 0..* Extension Schedule.actor.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Schedule.actor.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Schedule.actor.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Schedule.actor.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Schedule.actor.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Schedule.actor.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Schedule.actor.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Schedule.actor.display
hasValue() or (children().count() > id.count())
planningHorizon Σ 0..1 Period Schedule.planningHorizon
hasValue() or (children().count() > id.count())
comment 0..1 string Schedule.comment
hasValue() or (children().count() > id.count())
This resource is used to communicate details about the patient who is the subject of the booking. Information about an individual or animal receiving health care services SubjectOfCare Client Resident Demographics and other administrative information about an individual or animal receiving care or other health-related services. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) The registered place of birth of the patient. extensions, user content The registered place of birth of the patient. 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. http://hl7.org/fhir/StructureDefinition/patient-birthPlace Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The registered place of birth of the patient. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). The patient's phenotypic sex at birth. extensions, user content The patient's phenotypic sex at birth. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-BirthSex Post-mortem donor status. extensions, user content Flag indicating whether the patient authorized the donation of body parts after death. 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. http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Post-mortem donor status. Flag indicating whether the patient authorized the donation of body parts after death. The preferred method of contact, contact times and written communication format given by a Patient or Related Person. extensions, user content The preferred method of contact, contact times and written communication format given by a Patient or Related Person. 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. Extension(Complex) https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactPreference The patient's death notification status. extensions, user content The patient's death notification status. 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. Extension(Complex) https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-DeathNotificationStatus The ethnicity of the subject extensions, user content The ethnicity of the subject. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory The residential status of the patient. extensions, user content The residential status of the patient. For example if this patient is a UK resident. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ResidentialStatus The patient's professed religious affiliations extensions, user content The patient's professed religious affiliations. 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. http://hl7.org/fhir/StructureDefinition/patient-religion Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The religious affiliation of the patient The religious affiliation of the patient. v3.ReligiousAffiliation (extensible) Whether the patient needs an interpreter extensions, user content This Patient requires an interpreter to communicate healthcare information to the practitioner. The Patient does not speak the default language of the organization, and hence requires an interpreter. If the patient has other languages in the Communications list, then that would be the type of interpreter required. http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Indicator showing whether the patient needs an interpreter Indicator showing if this Patient requires an interpreter to communicate healthcare information to the practitioner. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. An identifier for this patient An identifier for this patient. Patients are almost always assigned specific numerical identifiers. Unordered, Open, by system(Value) The patient's NHS number An identifier for this patient. Patients are almost always assigned specific numerical identifiers. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) NHS number verification status extensions, user content The verification/tracing status of the NHS number. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this patient's record is in active use Whether this patient record is in active use.
Many systems use this property to mark as non-current patients, such as those that have not been seen for a period of time based on an organization's business rules. It is often used to filter patient lists to exclude inactive patients Deceased patients may also be marked as inactive for the same reasons, but may be active for some time after death. Need to be able to mark a patient record as not to be used because it was created in error. If a record is inactive, and linked to an active record, then future patient/record updates should occur on the other patient. This resource is generally assumed to be active if no value is provided for the active element A name associated with the patient A name associated with the individual. Need to be able to track the patient by multiple names. Examples are your official name and a partner name. A patient may have multiple names with different uses or applicable periods. For animals, the name is a "HumanName" in the sense that is assigned and used by humans and has the same patterns. A contact detail for the individual A contact detail (e.g. a telephone number or an email address) by which the individual may be contacted. People have (primary) ways to contact them in some way such as phone, email. A Patient may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and also to help with identification. The address might not go directly to the individual, but may reach another party that is able to proxy for the patient (i.e. home phone, or pet owner's phone). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) phone | fax | email | pager | url | sms | other Telecommunications form for contact point - what communications system is required to make use of the contact. Telecommunications form for contact point. xml:id (or equivalent in JSON) unique id for the element within a resource (for internal references) Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Other contact system extensions, user content Other contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem Primitive value for code Primitive value for code System.String The actual contact point details The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. home | work | temp | old | mobile - purpose of this contact point Identifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. Specify preferred order of use (1 = highest) Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Time period when the contact point was/is in use Time period when the contact point was/is in use. male | female | other | unknown Administrative Gender - the gender that the patient is considered to have for administration and record keeping purposes. Needed for identification of the individual, in combination with (at least) name and birth date. The gender might not match the biological sex as determined by genetics or the individual's preferred identification. Note that for both humans and particularly animals, there are other legitimate possibilities than male and female, though the vast majority of systems and contexts only support male and female. Systems providing decision support or enforcing business rules should ideally do this on the basis of Observations dealing with the specific sex or gender aspect of interest (anatomical, chromosomal, social, etc.) However, because these observations are infrequently recorded, defaulting to the administrative gender is common practice. Where such defaulting occurs, rule enforcement should allow for the variation between administrative and biological, chromosomal and other gender aspects. For example, an alert about a hysterectomy on a male should be handled as a warning or overridable error, not a "hard" error. See the Patient Gender and Sex section for additional information about communicating patient gender and sex. The gender of a person used for administrative purposes. The date of birth for the individual The date of birth for the individual. Age of the individual drives many clinical processes. At least an estimated year should be provided as a guess if the real DOB is unknown There is a standard extension "patient-birthTime" available that should be used where Time is required (such as in maternity/infant care systems). xml:id (or equivalent in JSON) unique id for the element within a resource (for internal references) Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Time of day of birth. extensions, user content The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. 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. http://hl7.org/fhir/StructureDefinition/patient-birthTime Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Time of day of birth. The time of day that the patient was born. This includes the date to ensure that the timezone information can be communicated effectively. Primitive value for date The actual value System.Date Indicates if the individual is deceased or not Indicates if the individual is deceased or not. The fact that a patient is deceased influences the clinical process. Also, in human communication and relation management it is necessary to know whether the person is alive. If there's no value in the instance, it means there is no statement on whether or not the individual is deceased. Most systems will interpret the absence of a value as a sign of the person being alive. An address for the individual An address for the individual May need to keep track of patient addresses for contacting, billing or reporting requirements and also to help with identification. Patient may have multiple addresses with different uses or applicable periods. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) A patient's address key and type extensions, user content A patient's address key and type. 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. Extension(Complex) https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-AddressKey home | work | temp | old | billing - purpose of this address The purpose of this address. Allows an appropriate address to be chosen from a list of many. Applications can assume that an address is current unless it explicitly says that it is temporary or old. The use of an address. postal | physical | both Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both. The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource). The type of an address (physical / postal). Text representation of the address Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts. A renderable, unencoded form. Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part. Street name, number, direction & P.O. Box etc. This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information. Name of city, town etc. Municpality The name of the city, town, suburb, village or other community or delivery center. District name (aka county) County The name of the administrative area (county). District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead. Sub-unit of country (abbreviations ok) Province, Territory Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes). Postal code for area Zip A postal code designating a region defined by the postal service. Country (e.g. can be ISO 3166 2 or 3 letter code) Country - a nation as commonly understood or generally accepted. ISO 3166 3 letter codes can be used in place of a human readable country name. Time period when address was/is in use Time period when address was/is in use. Allows addresses to be placed in historical context. Marital (civil) status of a patient This field contains a patient's most recent marital (civil) status. Most, if not all systems capture it. An indicator to identify the legal marital status of a person Whether patient is part of a multiple birth Indicates whether the patient is part of a multiple (boolean) or indicates the actual birth order (integer). For disambiguation of multiple-birth children, especially relevant where the care provider doesn't meet the patient, such as labs. Where the valueInteger is provided, the number is the birth number in the sequence. E.g. The middle birth in triplets would be valueInteger=2 and the third born would have valueInteger=3 If a boolean value was provided for this triplets example, then all 3 patient records would have valueBoolean=true (the ordering is not indicated). Image of the patient Image of the patient. Many EHR systems have the capability to capture an image of the patient. Fits with newer social media usage too. Guidelines: A contact party (e.g. guardian, partner, friend) for the patient A contact party (e.g. guardian, partner, friend) for the patient. Need to track people you can contact about the patient. Contact covers all kinds of contact parties: family members, business contacts, guardians, caregivers. Not applicable to register pedigree and family ties beyond use of having contact. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Preferred ranking or order of contact applied to a contact on a patient's contact list extensions, user content The preferred ranking or order of contact applied to a contact on a patient's contact list. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank Indicator showing that a patient's contact or related person must be copied in to patient correspondence extensions, user content Extension carrying a boolean indicator showing that a patient's contact or related person must be copied in to patient correspondence. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-CopyCorrespondenceIndicator Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The kind of relationship The nature of the relationship between the patient and the contact person. Used to determine which contact person is the most relevant to approach, depending on circumstances. The nature of the relationship between a patient and a contact person for that patient. A name associated with the contact person A name associated with the contact person. Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that contact person. A contact detail for the person A contact detail for the person, e.g. a telephone number or an email address. People have (primary) ways to contact them in some way such as phone, email. Contact may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) phone | fax | email | pager | url | sms | other Telecommunications form for contact point - what communications system is required to make use of the contact. Telecommunications form for contact point. xml:id (or equivalent in JSON) unique id for the element within a resource (for internal references) Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Other contact system extensions, user content Other contact system value which extends the system element in the ContactPoint datatype. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-OtherContactSystem Primitive value for code Primitive value for code System.String The actual contact point details The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address). Need to support legacy numbers that are not in a tightly controlled format. Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value. home | work | temp | old | mobile - purpose of this contact point Identifies the purpose for the contact point. Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose. Applications can assume that a contact is current unless it explicitly says that it is temporary or old. Use of contact point. Specify preferred order of use (1 = highest) Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values. Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Time period when the contact point was/is in use Time period when the contact point was/is in use. Address for the contact person Address for the contact person. Need to keep track where the contact person can be contacted per postal mail or visited. male | female | other | unknown Administrative Gender - the gender that the contact person is considered to have for administration and record keeping purposes. Needed to address the person correctly. The gender of a person used for administrative purposes. Organization that is associated with the contact Organization on behalf of which the contact is acting or for which the contact is working. For guardians or business related contacts, the organization is relevant. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The period during which this contact person or organization is valid to be contacted relating to this patient The period during which this contact person or organization is valid to be contacted relating to this patient. A language which may be used to communicate with the patient about his or her health A language which may be used to communicate with the patient about his or her health. If a patient does not speak the local language, interpreters may be required, so languages spoken and proficiency are important things to keep track of both for patient and other persons of interest. If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Patient.Communication associations. For animals, language is not a relevant field, and should be absent from the instance. If the Patient does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Proficiency level of the communication extensions, user content Proficiency level of the communication. 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. Extension(Complex) http://hl7.org/fhir/StructureDefinition/patient-proficiency Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) The proficiency level of the communication How well the patient can communicate this communication (good, poor, etc.). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The proficiency level for the communication The proficiency level for the communication. The proficiency level for the communication. The proficiency type of the communication What type of communication for the proficiency (spoken, written, etc.). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The proficiency type for the communication The proficiency type for the communication. The proficiency type for the communication. identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. Value of extension Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. A ValueSet that identifies the language used by a person. A ValueSet that identifies the language used by a person. Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect. The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. A ValueSet that identifies the language used by a person. Language preference indicator Indicates whether or not the patient prefers this language (over other languages he masters up a certain level). People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method. This language is specifically identified for communicating healthcare information. Patient's nominated primary care provider careProvider Patient's nominated care provider. This may be the primary care provider (in a GP context), or it may be a patient nominated care manager in a community/disability setting, or even organization that will provide people to perform the care provider roles. It is not to be used to record Care Teams, these should be in a CareTeam resource that may be linked to the CarePlan or EpisodeOfCare resources.
Multiple GPs may be recorded against the patient for various reasons, such as a student that has his home GP listed along with the GP at university during the school semesters, or a "fly-in/fly-out" worker that has the onsite GP also included with his home GP to remain aware of medical issues. Jurisdictions may decide that they can profile this down to 1 if desired, or 1 per type. Reference( | | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Organization that is the custodian of the patient record Organization that is the custodian of the patient record. Need to know who recognizes this patient record, manages and updates it. There is only one managing organization for a specific patient record. Other organizations will have their own Patient record, and may use the Link property to join the records together (or a Person resource which can include confidence ratings for the association). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Link to another patient resource that concerns the same actual person Link to another patient resource that concerns the same actual patient. There are multiple use cases: There is no assumption that linked patient records have mutual links. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The other patient or related person resource that the link refers to The other patient resource that the link refers to. Referencing a RelatedPerson here removes the need to use a Person record to associate a Patient and RelatedPerson as the same individual. Reference( | ) Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. replaced-by | replaces | refer | seealso The type of link between this patient resource and another patient resource. The type of link between this patient resource and another patient resource.
> Patient
It also includes contact information for third parties when required.UKCorePatient (Patient) I Patient Patient
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Patient.id
meta Σ 0..1 Meta Patient.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Patient.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Patient.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Patient.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Patient.contained
extension I 0..* Extension Element id Patient.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
birthPlace I 0..1 Extension(Address) Element id Patient.extension:birthPlace
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.extension:birthPlace.id
extension I 0..0 Extension Patient.extension:birthPlace.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.extension:birthPlace.url
http://hl7.org/fhir/StructureDefinition/patient-birthPlace
value[x] 1..1 Element id Patient.extension:birthPlace.value[x]
hasValue() or (children().count() > id.count())
valueAddress Address birthSex I 0..1 Extension(code) Element id Patient.extension:birthSex
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
cadavericDonor I 0..1 Extension(boolean) Element id Patient.extension:cadavericDonor
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.extension:cadavericDonor.id
extension I 0..0 Extension Patient.extension:cadavericDonor.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.extension:cadavericDonor.url
http://hl7.org/fhir/StructureDefinition/patient-cadavericDonor
value[x] 1..1 Element id Patient.extension:cadavericDonor.value[x]
hasValue() or (children().count() > id.count())
valueBoolean boolean contactPreference I 0..1 Extension(Complex) Element id Patient.extension:contactPreference
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
deathNotificationStatus I 0..1 Extension(Complex) Element id Patient.extension:deathNotificationStatus
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
ethnicCategory I 0..1 Extension(CodeableConcept) Element id Patient.extension:ethnicCategory
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
residentialStatus I 0..1 Extension(CodeableConcept) Element id Patient.extension:residentialStatus
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
patientReligion I 0..1 Extension(CodeableConcept) Element id Patient.extension:patientReligion
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.extension:patientReligion.id
extension I 0..0 Extension Patient.extension:patientReligion.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.extension:patientReligion.url
http://hl7.org/fhir/StructureDefinition/patient-religion
value[x] 1..1 Binding Element id Patient.extension:patientReligion.value[x]
hasValue() or (children().count() > id.count())
valueCodeableConcept CodeableConcept patientInterpreterRequired I 0..1 Extension(boolean) Element id Patient.extension:patientInterpreterRequired
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.extension:patientInterpreterRequired.id
extension I 0..0 Extension Patient.extension:patientInterpreterRequired.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.extension:patientInterpreterRequired.url
http://hl7.org/fhir/StructureDefinition/patient-interpreterRequired
value[x] 1..1 Element id Patient.extension:patientInterpreterRequired.value[x]
hasValue() or (children().count() > id.count())
valueBoolean boolean modifierExtension ?! I 0..* Extension Patient.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Element id Patient.identifier
hasValue() or (children().count() > id.count())
nhsNumber Σ 0..1 Identifier Element id Patient.identifier:nhsNumber
hasValue() or (children().count() > id.count())
id 0..1 string Patient.identifier:nhsNumber.id
extension I 0..* Extension Element id Patient.identifier:nhsNumber.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
nhsNumberVerificationStatus I 0..1 Extension(CodeableConcept) Element id Patient.identifier:nhsNumber.extension:nhsNumberVerificationStatus
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.identifier:nhsNumber.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.identifier:nhsNumber.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uriFixed Value Element id Patient.identifier:nhsNumber.system
hasValue() or (children().count() > id.count())
https://fhir.nhs.uk/Id/nhs-number
value Σ 1..1 string Patient.identifier:nhsNumber.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.identifier:nhsNumber.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.identifier:nhsNumber.assigner
hasValue() or (children().count() > id.count())
active Σ ?! 0..1 boolean Patient.active
hasValue() or (children().count() > id.count())
name Σ 0..* HumanName Patient.name
hasValue() or (children().count() > id.count())
telecom Σ 0..* ContactPoint Patient.telecom
hasValue() or (children().count() > id.count())
id 0..1 string Patient.telecom.id
extension I 0..* Extension Patient.telecom.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ I 0..1 codeBinding Patient.telecom.system
hasValue() or (children().count() > id.count())
id 0..1 string Patient.telecom.system.id
extension I 0..* Extension Element id Patient.telecom.system.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
otherContactSystem I 0..1 Extension(Coding) Element id Patient.telecom.system.extension:otherContactSystem
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
value 0..1 System.String Patient.telecom.system.value
value Σ 0..1 string Patient.telecom.value
hasValue() or (children().count() > id.count())
use Σ ?! 0..1 codeBinding Patient.telecom.use
hasValue() or (children().count() > id.count())
rank Σ 0..1 positiveInt Patient.telecom.rank
hasValue() or (children().count() > id.count())
period Σ 0..1 Period Patient.telecom.period
hasValue() or (children().count() > id.count())
gender Σ 0..1 codeBinding Patient.gender
hasValue() or (children().count() > id.count())
birthDate Σ 0..1 date Patient.birthDate
hasValue() or (children().count() > id.count())
id 0..1 string Patient.birthDate.id
extension I 0..* Extension Element id Patient.birthDate.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
birthTime I 0..1 Extension(dateTime) Element id Patient.birthDate.extension:birthTime
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.birthDate.extension:birthTime.id
extension I 0..0 Extension Patient.birthDate.extension:birthTime.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.birthDate.extension:birthTime.url
http://hl7.org/fhir/StructureDefinition/patient-birthTime
value[x] 1..1 Element id Patient.birthDate.extension:birthTime.value[x]
hasValue() or (children().count() > id.count())
valueDateTime dateTime value 0..1 System.Date Patient.birthDate.value
deceased[x] Σ ?! 0..1 Patient.deceased[x]
hasValue() or (children().count() > id.count())
deceasedBoolean boolean deceasedDateTime dateTime address Σ 0..* Address Element id Patient.address
hasValue() or (children().count() > id.count())
id 0..1 string Patient.address.id
extension I 0..* Extension Element id Patient.address.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
addressKey I 0..* Extension(Complex) Element id Patient.address.extension:addressKey
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.address.use
hasValue() or (children().count() > id.count())
home
Mappingstype Σ 0..1 codeBinding Patient.address.type
hasValue() or (children().count() > id.count())
both
Mappingstext Σ 0..1 string Patient.address.text
hasValue() or (children().count() > id.count())
137 Nowhere Street, Erewhon 9132
Mappingsline Σ 0..* string Patient.address.line
hasValue() or (children().count() > id.count())
137 Nowhere Street
Mappingscity Σ 0..1 string Patient.address.city
hasValue() or (children().count() > id.count())
Erewhon
Mappingsdistrict Σ 0..1 string Patient.address.district
hasValue() or (children().count() > id.count())
Madison
Mappingsstate Σ 0..1 string Patient.address.state
hasValue() or (children().count() > id.count())
postalCode Σ 0..1 string Patient.address.postalCode
hasValue() or (children().count() > id.count())
9132
Mappingscountry Σ 0..1 string Patient.address.country
hasValue() or (children().count() > id.count())
period Σ 0..1 Period Patient.address.period
hasValue() or (children().count() > id.count())
{
"start": "2010-03-23",
"end": "2010-07-01"
}
MappingsmaritalStatus 0..1 CodeableConceptBinding Element id Patient.maritalStatus
hasValue() or (children().count() > id.count())
multipleBirth[x] 0..1 Patient.multipleBirth[x]
hasValue() or (children().count() > id.count())
multipleBirthBoolean boolean multipleBirthInteger integer photo 0..* Attachment Patient.photo
hasValue() or (children().count() > id.count())
contact I 0..* BackboneElement Patient.contact
hasValue() or (children().count() > id.count())
name.exists() or telecom.exists() or address.exists() or organization.exists()
id 0..1 string Patient.contact.id
extension I 0..* Extension Element id Patient.contact.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
contactRank I 0..1 Extension(positiveInt) Element id Patient.contact.extension:contactRank
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
copyCorrespondenceIndicator I 0..1 Extension(boolean) Element id Patient.contact.extension:copyCorrespondenceIndicator
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Patient.contact.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
relationship 0..* CodeableConceptBinding Element id Patient.contact.relationship
hasValue() or (children().count() > id.count())
name 0..1 HumanName Patient.contact.name
hasValue() or (children().count() > id.count())
telecom 0..* ContactPoint Patient.contact.telecom
hasValue() or (children().count() > id.count())
id 0..1 string Patient.contact.telecom.id
extension I 0..* Extension Patient.contact.telecom.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
system Σ I 0..1 codeBinding Patient.contact.telecom.system
hasValue() or (children().count() > id.count())
id 0..1 string Patient.contact.telecom.system.id
extension I 0..* Extension Element id Patient.contact.telecom.system.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
otherContactSystem I 0..1 Extension(Coding) Element id Patient.contact.telecom.system.extension:otherContactSystem
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
value 0..1 System.String Patient.contact.telecom.system.value
value Σ 0..1 string Patient.contact.telecom.value
hasValue() or (children().count() > id.count())
use Σ ?! 0..1 codeBinding Patient.contact.telecom.use
hasValue() or (children().count() > id.count())
rank Σ 0..1 positiveInt Patient.contact.telecom.rank
hasValue() or (children().count() > id.count())
period Σ 0..1 Period Patient.contact.telecom.period
hasValue() or (children().count() > id.count())
address 0..1 Address Patient.contact.address
hasValue() or (children().count() > id.count())
gender 0..1 codeBinding Patient.contact.gender
hasValue() or (children().count() > id.count())
organization I 0..1 Reference() Element id Patient.contact.organization
hasValue() or (children().count() > id.count())
id 0..1 string Patient.contact.organization.id
extension I 0..* Extension Patient.contact.organization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Patient.contact.organization.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Patient.contact.organization.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Patient.contact.organization.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Patient.contact.organization.identifier.id
extension I 0..* Extension Patient.contact.organization.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.contact.organization.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.contact.organization.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Patient.contact.organization.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Patient.contact.organization.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.contact.organization.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.contact.organization.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Patient.contact.organization.display
hasValue() or (children().count() > id.count())
period 0..1 Period Patient.contact.period
hasValue() or (children().count() > id.count())
communication 0..* BackboneElement Patient.communication
hasValue() or (children().count() > id.count())
id 0..1 string Patient.communication.id
extension I 0..* Extension Element id Patient.communication.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
proficiency I 0..1 Extension(Complex) Element id Patient.communication.extension:proficiency
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.communication.extension:proficiency.id
extension I 0..* Extension Element id Patient.communication.extension:proficiency.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
level I 0..1 Extension Patient.communication.extension:proficiency.extension:level
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.communication.extension:proficiency.extension:level.id
extension I 0..0 Extension Patient.communication.extension:proficiency.extension:level.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.communication.extension:proficiency.extension:level.url
level
value[x] 1..1 Binding Element id Patient.communication.extension:proficiency.extension:level.value[x]
hasValue() or (children().count() > id.count())
valueCoding Coding type I 0..* Extension Patient.communication.extension:proficiency.extension:type
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Patient.communication.extension:proficiency.extension:type.id
extension I 0..0 Extension Patient.communication.extension:proficiency.extension:type.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Patient.communication.extension:proficiency.extension:type.url
type
value[x] 1..1 Binding Element id Patient.communication.extension:proficiency.extension:type.value[x]
hasValue() or (children().count() > id.count())
valueCoding Coding url 1..1 uriFixed Value Patient.communication.extension:proficiency.url
http://hl7.org/fhir/StructureDefinition/patient-proficiency
value[x] 0..0 Patient.communication.extension:proficiency.value[x]
hasValue() or (children().count() > id.count())
modifierExtension Σ ?! I 0..* Extension Patient.communication.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
language 1..1 CodeableConceptBinding Element id Patient.communication.language
hasValue() or (children().count() > id.count())
preferred 0..1 boolean Patient.communication.preferred
hasValue() or (children().count() > id.count())
generalPractitioner 0..* Reference( | | ) Element id Patient.generalPractitioner
hasValue() or (children().count() > id.count())
id 0..1 string Patient.generalPractitioner.id
extension I 0..* Extension Patient.generalPractitioner.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Patient.generalPractitioner.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Patient.generalPractitioner.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Patient.generalPractitioner.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Patient.generalPractitioner.identifier.id
extension I 0..* Extension Patient.generalPractitioner.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.generalPractitioner.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.generalPractitioner.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Patient.generalPractitioner.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Patient.generalPractitioner.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.generalPractitioner.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.generalPractitioner.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Patient.generalPractitioner.display
hasValue() or (children().count() > id.count())
managingOrganization Σ 0..1 Reference() Element id Patient.managingOrganization
hasValue() or (children().count() > id.count())
id 0..1 string Patient.managingOrganization.id
extension I 0..* Extension Patient.managingOrganization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Patient.managingOrganization.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Patient.managingOrganization.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Patient.managingOrganization.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Patient.managingOrganization.identifier.id
extension I 0..* Extension Patient.managingOrganization.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.managingOrganization.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.managingOrganization.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Patient.managingOrganization.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Patient.managingOrganization.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.managingOrganization.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.managingOrganization.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Patient.managingOrganization.display
hasValue() or (children().count() > id.count())
link Σ ?! 0..* BackboneElement Patient.link
hasValue() or (children().count() > id.count())
id 0..1 string Patient.link.id
extension I 0..* Extension Patient.link.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Patient.link.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
other Σ 1..1 Reference( | ) Element id Patient.link.other
hasValue() or (children().count() > id.count())
id 0..1 string Patient.link.other.id
extension I 0..* Extension Patient.link.other.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Patient.link.other.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Patient.link.other.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Patient.link.other.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Patient.link.other.identifier.id
extension I 0..* Extension Patient.link.other.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Patient.link.other.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Patient.link.other.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Patient.link.other.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Patient.link.other.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Patient.link.other.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Patient.link.other.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Patient.link.other.display
hasValue() or (children().count() > id.count())
type Σ 1..1 codeBinding Patient.link.type
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Cadinality UKCore
Example Value(s)
Patient
https://simplifier.net/hl7fhirukcorer4/ukcore-patient
1..1
Patient.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
9589fb37-87a2-48d8-968f-b371429208a8
Patient.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Patient.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient
Patient.meta.LastUpdate
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Patient.identifier
SHOULD
0..*
Patient.identifier.system
This SHOULD be populated with namespace for the Identifier
SHOULD
0..*
https://fhir.nhs.uk/Id/nhs-number
Patient.identifier.value
This SHOULD be populated with a human readable patient identifier. When used this MUST be populated with the NHS number when available.If no NHS number is available this SHOULD be populated with the Local patient identifier.
SHOULD
1..1
3478526985
Patient.identifier.extension
This extension is used to record the NHS number Verification status
SHOULD
Patient.identifier.extension.url
This SHOULD be populated. Where used this MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus' - FIXED VALUE
SHOULD
0..1
https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-NHSNumberVerificationStatus
Patient.identifier.extension.valueCodeableConcept
SHOULD
0..1
Patient.identifier.extension.valueCodeableConcept.coding
SHOULD
0..1
Patient.identifier.extension.valueCodeableConcept.coding.system
This SHOULD be populated. Where used this MUST be populated with CodeSystem - 'https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus' - FIXED VALUE
SHOULD
0..1
https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatus
Patient.identifier.extension.valueCodeableConcept.coding.code
This SHOULD be populated. Where used this MUST either be number-present-and-verified or no NHS number MUST be sent, no other status is valid
SHOULD
1..1
number-present-and-verified
Patient.identifier.extension.valueCodeableConcept.coding.display
This SHOULD be populated. Where used this MUST either be populated with 'Number present and-verified' no other status is valid
MAY
1..1
Number present and verified
Patient.name
SHOULD
0..*
Patient.name.use
Follow UK Core guidance for populating this element
SHOULD
0..1
official
Patient.name.text
Follow UK Core guidance for populating this element
SHOULD
0..1
Mrs Julie Jones
Patient.name.family
Follow UK Core guidance for populating this element
SHOULD
0..1
Jones
Patient.name.given
Follow UK Core guidance for populating this element
SHOULD
0..1
Julie
Patient.name.prefix
Follow UK Core guidance for populating this element
SHOULD
0..1
Mrs
Patient.gender
Follow UK Core guidance for populating this element
SHOULD
0..1
female
Patient.birthDate
Follow UK Core guidance for populating this element
SHOULD
0..1
1959-05-04
Patient.address
SHOULD
0..*
Patient.address.use
This SHOULD be populated. Where used 'home' MUST only be used for the patient's official residing address. 'temp' is used for alternative current locations with an address format, otherwise, a Location resource can be used to pinpoint a location without a building address
SHOULD
0..1
home
Patient.address.type
Follow UK Core guidance for populating this element
SHOULD
0..1
both
Patient.address.text
Follow UK Core guidance for populating this element
SHOULD
0..1
22 Brightside Crescent, Overtown, West Yorkshire, LS10 4YU
Patient.address.line
Follow UK Core guidance for populating this element
SHOULD
0..*
22 Brightside Crescent
Patient.address.city
Follow UK Core guidance for populating this element
SHOULD
0..1
Overtown
Patient.address.district
Follow UK Core guidance for populating this element
SHOULD
0..1
West Yorkshire
Patient.address.postalCode
Follow UK Core guidance for populating this element
SHOULD
0..1
LS10 4YU
Patient.contact
This MUST be used to record telecom information for the patient and/or the patient's representative for the encounter
MUST
0..*
Patient.contact.extension
MUST
0..*
Patient.contact.extension.url
This MUST be populated with Structure Definition 'https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank' - FIXED VALUE
MUST
0..1
https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-ContactRank
Patient.contact.extension.urlvaluePositiveInt
This MUST be populated with the rank of the whole contact and MUST be populated with the value '1' for the primary person to contact for referral. There MUST be at least one contact for the referral.
MUST
0..1
1
Patient.contact.relationship
MUST
0..1
Patient.contact.relationship.coding
MUST
0..1
Patient.contact.relationship.coding.system
This MUST be populated with the CodeSystem from the ValueSet 'https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-personrelationshiptype'.
Where the contact details relate to the patient this relationship MUST be populated with the value 'self'.
Where the contact details relate to a patient's representative this SHOULD be populated with their relationship to the patient.
If the relationship is not known this SHOULD be populated with the value 'Unknown'MUST
0..1
http://terminology.hl7.org/CodeSystem/v2-0131
Patient.contact.relationship.coding.code
This MUST be populated with Code of CodeSystem value. See ValueSet 'https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-personrelationshiptype'.
MUST
0..1
EP
Patient.contact.relationship.coding.display
This MUST be populated with Display of CodeSystem value. See ValueSet 'https://simplifier.net/hl7fhirukcorer4/valueset-ukcore-personrelationshiptype'.
MUST
0..1
EP
Patient.contact.name
SHOULD
0..1
Patient.contact.name.family
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
Grayson
Patient.contact.name.given
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
Jack
Patient.contact.telecom
SHOULD
0..*
Patient.contact.telecom.system
This MUST be populated for the rank 1 contact. There MUST be at least one contact phone number for the referral
MUST
phone
Patient.contact.telecom.value
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
0789 1234567
Patient.contact.gender
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
male
Patient.Communication
SHOULD
0..1
Patient.Communication.Language
SHOULD
0..1
Patient.Communication.Language.coding
SHOULD
0..1
Patient.Communication.Language.coding.code
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..*
en
Patient.Communication.Language.coding.system
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
https://fhir.hl7.org.uk/CodeSystem/UKCore-HumanLanguage
Patient.Communication.Language.coding.display
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
English
Patient.Communication.Language.preferred
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
TRUE
Patient.extension
SHOULD
0..*
Patient.extension.url
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
1..1
https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-EthnicCategory
Patient.extension.valueCodeableConcept
SHOULD
0..1
Patient.extension.valueCodeableConcept.coding
SHOULD
0..*
Patient.extension.valueCodeableConcept.coding.system
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
https://fhir.hl7.org.uk/CodeSystem/UKCore-EthnicCategory
Patient.extension.valueCodeableConcept.coding.code
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
A
Patient.extension.valueCodeableConcept.coding.display
This SHOULD be populated. Follow UK Core guidance for populating this element
SHOULD
0..1
British, Mixed British
Patient.generalPractitioner
This SHOULD be populated with a reference to the GP Surgery ONLY rather than a specific practitioner
SHOULD
0..1
Patient.generalPractitioner.reference
This SHOULD be populated. Where populated this MUST reference to an Organisation resource
SHOULD
0..1
urn:uuid:b83d13e2-8c2e-422c-88ac-63b8e86a4411
This resource is used to communicate details about the sender and receiver organisations. A grouping of people or organizations with a common purpose A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Main location extensions, user content The main location of the organisation. 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. https://fhir.hl7.org.uk/StructureDefinition/Extension-UKCore-MainLocation The date range that this organization should be considered available. extensions, user content The date range that this organization should be considered available. 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. http://hl7.org/fhir/StructureDefinition/organization-period Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Extension An Extension Unordered, Open, by url(Value) identifies the meaning of the extension Source of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The date range that this organization should be considered available. The date range that this organization should be considered available. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Identifies this organization across multiple systems Identifier for the organization that is used to identify the organization across multiple disparate systems. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Unordered, Open, by system(Value) Organisation Data Service code Identifier code supplier by the Organisation Data Service. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. ODS Site code to identify the organisation at site level ODS Site code to identify the organisation at site level. Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether the organization's record is still in active use Whether the organization's record is still in active use. Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI. This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used. This element is labeled as a modifier because it may be used to mark that the resource was created in error. This resource is generally assumed to be active if no value is provided for the active element Kind of organization The kind(s) of organization that this is. Need to be able to track the kind of organization that this is - different organization types have different uses. Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center. We expect that some jurisdictions will profile this optionality to be a single cardinality. Used to categorize the organization. Name used for the organization A name associated with the organization. Need to use the name as the label of the organization. If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches. A list of alternate names that the organization is known as, or was known as in the past A list of alternate names that the organization is known as, or was known as in the past. Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the organization was known by can be very useful. There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization. A contact detail for the organization A contact detail for the organization. Human contact for the organization. The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself. An address for the organization An address for the organization. May need to keep track of the organization's addresses for contacting, billing or reporting requirements. Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used. The organization of which this organization forms a part The organization of which this organization forms a part. Need to be able to track the hierarchy of organizations within an organization. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Contact for the organization for a certain purpose Contact for the organization for a certain purpose. Need to keep track of assigned contact points within bigger organization. Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The type of contact Indicates a purpose for which the contact can be reached. Need to distinguish between multiple contact persons. The purpose for which you would contact a contact party. A name associated with the contact A name associated with the contact. Need to be able to track the person by name. Contact details (telephone, email, etc.) for a contact A contact detail (e.g. a telephone number or an email address) by which the party may be contacted. People have (primary) ways to contact them in some way such as phone, email. Visiting or postal addresses for the contact Visiting or postal addresses for the contact. May need to keep track of a contact party's address for contacting, billing or reporting requirements. Technical endpoints providing access to services operated for the organization Technical endpoints providing access to services operated for the organization. Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
> Organization
UKCoreOrganization (Organization) I Organization Organization
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
(identifier.count() + name.count()) > 0
id Σ 0..1 string Organization.id
meta Σ 0..1 Meta Organization.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Organization.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Organization.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Organization.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Organization.contained
extension I 0..* Extension Element id Organization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
mainLocation I 0..* Extension(Reference()) Element id Organization.extension:mainLocation
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
organizationPeriod I 0..1 Extension(Period) Element id Organization.extension:organizationPeriod
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
id 0..1 string Organization.extension:organizationPeriod.id
extension I 0..0 Extension Organization.extension:organizationPeriod.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
url 1..1 uriFixed Value Organization.extension:organizationPeriod.url
http://hl7.org/fhir/StructureDefinition/organization-period
value[x] 1..1 Element id Organization.extension:organizationPeriod.value[x]
hasValue() or (children().count() > id.count())
valuePeriod Period modifierExtension ?! I 0..* Extension Organization.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ I 0..* Identifier Element id Organization.identifier
hasValue() or (children().count() > id.count())
odsOrganisationCode Σ I 0..1 Identifier Element id Organization.identifier:odsOrganisationCode
hasValue() or (children().count() > id.count())
id 0..1 string Organization.identifier:odsOrganisationCode.id
extension I 0..* Extension Organization.identifier:odsOrganisationCode.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Organization.identifier:odsOrganisationCode.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Organization.identifier:odsOrganisationCode.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uriFixed Value Element id Organization.identifier:odsOrganisationCode.system
hasValue() or (children().count() > id.count())
https://fhir.nhs.uk/Id/ods-organization-code
value Σ 1..1 string Organization.identifier:odsOrganisationCode.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Organization.identifier:odsOrganisationCode.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Organization.identifier:odsOrganisationCode.assigner
hasValue() or (children().count() > id.count())
odsSiteCode Σ I 0..1 Identifier Element id Organization.identifier:odsSiteCode
hasValue() or (children().count() > id.count())
id 0..1 string Organization.identifier:odsSiteCode.id
extension I 0..* Extension Organization.identifier:odsSiteCode.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Organization.identifier:odsSiteCode.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Organization.identifier:odsSiteCode.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uriFixed Value Element id Organization.identifier:odsSiteCode.system
hasValue() or (children().count() > id.count())
https://fhir.nhs.uk/Id/ods-site-code
value Σ 1..1 string Organization.identifier:odsSiteCode.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Organization.identifier:odsSiteCode.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Organization.identifier:odsSiteCode.assigner
hasValue() or (children().count() > id.count())
active Σ ?! 0..1 boolean Organization.active
hasValue() or (children().count() > id.count())
type Σ 0..* CodeableConcept Organization.type
hasValue() or (children().count() > id.count())
name Σ I 0..1 string Organization.name
hasValue() or (children().count() > id.count())
alias 0..* string Organization.alias
hasValue() or (children().count() > id.count())
telecom I 0..* ContactPoint Organization.telecom
hasValue() or (children().count() > id.count())
where(use = 'home').empty()
address I 0..* Address Organization.address
hasValue() or (children().count() > id.count())
where(use = 'home').empty()
partOf Σ 0..1 Reference() Element id Organization.partOf
hasValue() or (children().count() > id.count())
id 0..1 string Organization.partOf.id
extension I 0..* Extension Organization.partOf.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Organization.partOf.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Organization.partOf.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Organization.partOf.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Organization.partOf.identifier.id
extension I 0..* Extension Organization.partOf.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Organization.partOf.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Organization.partOf.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Organization.partOf.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Organization.partOf.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Organization.partOf.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Organization.partOf.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Organization.partOf.display
hasValue() or (children().count() > id.count())
contact 0..* BackboneElement Organization.contact
hasValue() or (children().count() > id.count())
id 0..1 string Organization.contact.id
extension I 0..* Extension Organization.contact.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Organization.contact.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
purpose 0..1 CodeableConceptBinding Organization.contact.purpose
hasValue() or (children().count() > id.count())
name 0..1 HumanName Organization.contact.name
hasValue() or (children().count() > id.count())
telecom 0..* ContactPoint Organization.contact.telecom
hasValue() or (children().count() > id.count())
address 0..1 Address Organization.contact.address
hasValue() or (children().count() > id.count())
endpoint 0..* Reference(Endpoint) Organization.endpoint
hasValue() or (children().count() > id.count())
id 0..1 string Organization.endpoint.id
extension I 0..* Extension Organization.endpoint.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Organization.endpoint.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Organization.endpoint.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Organization.endpoint.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Organization.endpoint.identifier.id
extension I 0..* Extension Organization.endpoint.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Organization.endpoint.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Organization.endpoint.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Organization.endpoint.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Organization.endpoint.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Organization.endpoint.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Organization.endpoint.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Organization.endpoint.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Cadinality UKCore
Example Value(s)
Organization
https://simplifier.net/hl7fhirukcorer4/ukcore-organization
2..*
Organization.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
5d897313-c62d-4e7e-92b7-b2199804fed3
Organization.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Organization.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization
Organization.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Organization.identifier
This MUST be populated with an organisation identifier e.g. ODS code
MUST
0..*
Organization.identifier.system
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
https://fhir.nhs.uk/id/ods-organization-code
Organization.identifier.value
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
ABD01
Organization.name
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
Organisation name
This is used to carry details of the healthcare professional making the Booking A person with a formal responsibility in the provisioning of healthcare or related services A person who is directly or indirectly involved in the provisioning of healthcare. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. An identifier for the person as this agent An identifier that applies to this person in this role. Often, specific identities are assigned for the agent. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this practitioner's record is in active use Whether this practitioner's record is in active use. Need to be able to mark a practitioner record as not to be used because it was created in error. If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role. This resource is generally assumed to be active if no value is provided for the active element The name(s) associated with the practitioner The name(s) associated with the practitioner. The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display. The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate. In general, select the value to be used in the ResourceReference.display based on this: A contact detail for the practitioner (that apply to all roles) A contact detail for the practitioner, e.g. a telephone number or an email address. Need to know how to reach a practitioner independent to any roles the practitioner may have. Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific. Address(es) of the practitioner that are not role specific (typically home address) 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. The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations. The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address). male | female | other | unknown Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes. Needed to address the person correctly. The gender of a person used for administrative purposes. The date on which the practitioner was born The date of birth for the practitioner. Needed for identification. Image of the person Image of the person. Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too. Certification, licenses, or training pertaining to the provision of care 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. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. An identifier for this qualification for the practitioner An identifier that applies to this person's qualification in this role. Often, specific identities are assigned for the qualification. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Coded representation of the qualification Coded representation of the qualification. Specific qualification the practitioner has to provide a service. Period during which the qualification is valid Period during which the qualification is valid. Qualifications are often for a limited period of time, and can be revoked. Organization that regulates and issues the qualification Organization that regulates and issues the qualification. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. A language the practitioner can use in patient communication A language the practitioner can use in patient communication. Knowing which language a practitioner speaks can help in facilitating communication with patients. 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. A human language.
> Practitioner
UKCorePractitioner (Practitioner) I Practitioner Practitioner
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string Practitioner.id
meta Σ 0..1 Meta Practitioner.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri Practitioner.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding Practitioner.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative Practitioner.text
hasValue() or (children().count() > id.count())
contained 0..* Resource Practitioner.contained
extension I 0..* Extension Practitioner.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension Practitioner.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Practitioner.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.identifier.id
extension I 0..* Extension Practitioner.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Practitioner.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Practitioner.identifier.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uri Practitioner.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 1..1 string Practitioner.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Practitioner.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Practitioner.identifier.assigner
hasValue() or (children().count() > id.count())
active Σ 0..1 boolean Practitioner.active
hasValue() or (children().count() > id.count())
name Σ 0..* HumanName Practitioner.name
hasValue() or (children().count() > id.count())
telecom Σ 0..* ContactPoint Practitioner.telecom
hasValue() or (children().count() > id.count())
address Σ 0..* Address Practitioner.address
hasValue() or (children().count() > id.count())
gender Σ 0..1 codeBinding Practitioner.gender
hasValue() or (children().count() > id.count())
birthDate Σ 0..1 date Practitioner.birthDate
hasValue() or (children().count() > id.count())
photo 0..* Attachment Practitioner.photo
hasValue() or (children().count() > id.count())
qualification 0..* BackboneElement Practitioner.qualification
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.qualification.id
extension I 0..* Extension Practitioner.qualification.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension Practitioner.qualification.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier 0..* Identifier Practitioner.qualification.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.qualification.identifier.id
extension I 0..* Extension Practitioner.qualification.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Practitioner.qualification.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Practitioner.qualification.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Practitioner.qualification.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Practitioner.qualification.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Practitioner.qualification.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Practitioner.qualification.identifier.assigner
hasValue() or (children().count() > id.count())
code 1..1 CodeableConcept Practitioner.qualification.code
hasValue() or (children().count() > id.count())
period 0..1 Period Practitioner.qualification.period
hasValue() or (children().count() > id.count())
issuer 0..1 Reference() Element id Practitioner.qualification.issuer
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.qualification.issuer.id
extension I 0..* Extension Practitioner.qualification.issuer.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string Practitioner.qualification.issuer.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding Practitioner.qualification.issuer.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier Practitioner.qualification.issuer.identifier
hasValue() or (children().count() > id.count())
id 0..1 string Practitioner.qualification.issuer.identifier.id
extension I 0..* Extension Practitioner.qualification.issuer.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding Practitioner.qualification.issuer.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding Practitioner.qualification.issuer.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri Practitioner.qualification.issuer.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string Practitioner.qualification.issuer.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period Practitioner.qualification.issuer.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id Practitioner.qualification.issuer.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string Practitioner.qualification.issuer.display
hasValue() or (children().count() > id.count())
communication 0..* CodeableConceptBinding Practitioner.communication
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Cadinality UKCore
Example Value(s)
Practitioner
https://simplifier.net/hl7fhirukcorer4/ukcore-practitioner
0..*
Practitioner.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
1..1
51182cb1-b199-4222-85f5-16d5428f6358
Practitioner.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
Practitioner.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner
Practitioner.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
Practitioner.identifier
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..*
Practitioner.identifier.system
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
https://fhir.nhs.uk/Id/sds-role-profile-id
Practitioner.identifier.value
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
PT2489
Practitioner.name
SHOULD
0..*
Practitioner.name.family
Follow UK Core guidance for populating this element
SHOULD
0..1
BLAKE
Practitioner.name.given
Follow UK Core guidance for populating this element
SHOULD
0..1
Marcy
Practitioner.telecom
SHOULD
0..*
Practitioner.telecom.system
Follow UK Core guidance for populating this element
SHOULD
0..1
phone
Practitioner.telecom.value
Follow UK Core guidance for populating this element
SHOULD
0..1
0205568263
Practitioner.telecom.use
Follow UK Core guidance for populating this element
SHOULD
0..1
work
This is used to carry the role of the practitioner making the referral. Note this may be the call handler Roles/organizations the practitioner is associated with A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. An identifier that applies to this person in this role. An identifier that applies to this person in this role. Often, specific identities are assigned for the agent. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this practitioner role record is in active use Whether this practitioner role record is in active use. 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. 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. This resource is generally assumed to be active if no value is provided for the active element The period during which the practitioner is authorized to perform in these role(s) The period during which the person is authorized to act as a practitioner in these role(s) for the organization. Even after the agencies is revoked, the fact that it existed must still be recorded. Practitioner that is able to provide the defined services for the organization Practitioner that is able to provide the defined services for the organization. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Organization where the roles are available The organization where the Practitioner performs the roles associated. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Roles which this practitioner may perform Roles which this practitioner is authorized to perform for the organization. Need to know what authority the practitioner has - what can they do? A person may have more than one role. The role a person plays representing an organization. Specific specialty of the practitioner Specific specialty of the practitioner. Specific specialty associated with the agency. The location(s) at which this practitioner provides care The location(s) at which this practitioner provides care. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. The list of healthcare services that this worker provides for this role's Organization/Location(s) The list of healthcare services that this worker provides for this role's Organization/Location(s). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Contact details that are specific to the role/location/service Contact details that are specific to the role/location/service. 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. Times the Service Site is available A collection of times the practitioner is available or performing this role at the location and/or healthcareservice. More detailed availability information may be provided in associated Schedule/Slot resources. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. mon | tue | wed | thu | fri | sat | sun Indicates which days of the week are available between the start and end Times. The days of the week. Always available? e.g. 24 hour service Is this always available? (hence times are irrelevant) e.g. 24 hour service. Opening time of day (ignored if allDay = true) The opening time of day. Note: If the AllDay flag is set, then this time is ignored. The timezone is expected to be for where this HealthcareService is provided at. Closing time of day (ignored if allDay = true) The closing time of day. Note: If the AllDay flag is set, then this time is ignored. The timezone is expected to be for where this HealthcareService is provided at. Not available during this time due to provided reason The practitioner is not available or performing this role during this period of time due to the provided reason. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Reason presented to the user explaining why time not available The reason that can be presented to the user as to why this time is not available. Service not available from this date Service is not available (seasonally or for a public holiday) from this date. Description of availability exceptions 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. Technical endpoints providing access to services operated for the practitioner with this role Technical endpoints providing access to services operated for the practitioner with this role. 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. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
> Practitioner Role
UKCorePractitionerRole (PractitionerRole) I PractitionerRole PractitionerRole
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string PractitionerRole.id
meta Σ 0..1 Meta PractitionerRole.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri PractitionerRole.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding PractitionerRole.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative PractitionerRole.text
hasValue() or (children().count() > id.count())
contained 0..* Resource PractitionerRole.contained
extension I 0..* Extension PractitionerRole.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension PractitionerRole.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier Element id PractitionerRole.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.identifier.id
extension I 0..* Extension PractitionerRole.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.identifier.type
hasValue() or (children().count() > id.count())
system Σ 1..1 uri PractitionerRole.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 1..1 string PractitionerRole.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.identifier.assigner
hasValue() or (children().count() > id.count())
active Σ 0..1 boolean PractitionerRole.active
hasValue() or (children().count() > id.count())
period Σ 0..1 Period PractitionerRole.period
hasValue() or (children().count() > id.count())
practitioner Σ 0..1 Reference() Element id PractitionerRole.practitioner
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.practitioner.id
extension I 0..* Extension PractitionerRole.practitioner.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.practitioner.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.practitioner.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.practitioner.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.practitioner.identifier.id
extension I 0..* Extension PractitionerRole.practitioner.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.practitioner.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.practitioner.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.practitioner.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.practitioner.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.practitioner.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.practitioner.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.practitioner.display
hasValue() or (children().count() > id.count())
organization Σ 0..1 Reference() Element id PractitionerRole.organization
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.organization.id
extension I 0..* Extension PractitionerRole.organization.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.organization.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.organization.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.organization.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.organization.identifier.id
extension I 0..* Extension PractitionerRole.organization.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.organization.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.organization.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.organization.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.organization.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.organization.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.organization.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.organization.display
hasValue() or (children().count() > id.count())
code Σ 0..* CodeableConceptBinding Element id PractitionerRole.code
hasValue() or (children().count() > id.count())
specialty Σ 0..* CodeableConceptBinding PractitionerRole.specialty
hasValue() or (children().count() > id.count())
location Σ 0..* Reference() Element id PractitionerRole.location
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.location.id
extension I 0..* Extension PractitionerRole.location.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.location.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.location.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.location.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.location.identifier.id
extension I 0..* Extension PractitionerRole.location.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.location.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.location.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.location.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.location.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.location.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.location.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.location.display
hasValue() or (children().count() > id.count())
healthcareService 0..* Reference(HealthcareService) PractitionerRole.healthcareService
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.healthcareService.id
extension I 0..* Extension PractitionerRole.healthcareService.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.healthcareService.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.healthcareService.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.healthcareService.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.healthcareService.identifier.id
extension I 0..* Extension PractitionerRole.healthcareService.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.healthcareService.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.healthcareService.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.healthcareService.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.healthcareService.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.healthcareService.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.healthcareService.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.healthcareService.display
hasValue() or (children().count() > id.count())
telecom Σ 0..* ContactPoint PractitionerRole.telecom
hasValue() or (children().count() > id.count())
availableTime 0..* BackboneElement PractitionerRole.availableTime
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.availableTime.id
extension I 0..* Extension PractitionerRole.availableTime.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension PractitionerRole.availableTime.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
daysOfWeek 0..* codeBinding PractitionerRole.availableTime.daysOfWeek
hasValue() or (children().count() > id.count())
allDay 0..1 boolean PractitionerRole.availableTime.allDay
hasValue() or (children().count() > id.count())
availableStartTime 0..1 time PractitionerRole.availableTime.availableStartTime
hasValue() or (children().count() > id.count())
availableEndTime 0..1 time PractitionerRole.availableTime.availableEndTime
hasValue() or (children().count() > id.count())
notAvailable 0..* BackboneElement PractitionerRole.notAvailable
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.notAvailable.id
extension I 0..* Extension PractitionerRole.notAvailable.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension PractitionerRole.notAvailable.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
description 1..1 string PractitionerRole.notAvailable.description
hasValue() or (children().count() > id.count())
during 0..1 Period PractitionerRole.notAvailable.during
hasValue() or (children().count() > id.count())
availabilityExceptions 0..1 string PractitionerRole.availabilityExceptions
hasValue() or (children().count() > id.count())
endpoint 0..* Reference(Endpoint) PractitionerRole.endpoint
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.endpoint.id
extension I 0..* Extension PractitionerRole.endpoint.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string PractitionerRole.endpoint.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding PractitionerRole.endpoint.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier PractitionerRole.endpoint.identifier
hasValue() or (children().count() > id.count())
id 0..1 string PractitionerRole.endpoint.identifier.id
extension I 0..* Extension PractitionerRole.endpoint.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding PractitionerRole.endpoint.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding PractitionerRole.endpoint.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri PractitionerRole.endpoint.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string PractitionerRole.endpoint.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period PractitionerRole.endpoint.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id PractitionerRole.endpoint.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string PractitionerRole.endpoint.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Cadinality UKCore
Example Value(s)
PractitionerRole
https://simplifier.net/hl7fhirukcorer4/ukcore-practitionerrole
0..*
PractitionerRole.id
This MUST only be populated with an id generated by the Receiver in the synchronous HTTP response.
MUST
1..1
1801e180-e6a1-4753-8a55-ab2d1cff6549
PractitionerRole.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
PractitionerRole.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole
PractitionerRole.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
PractitionerRole.practitioner
MUST
0..1
PractitionerRole.practitioner.reference
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb56
PractitionerRole.Organisation
MUST
0..1
PractitionerRole.Organisation.reference
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
urn:uuid:7d948662-bade-450e-b6c5-9bb6ee39cb51
PractitionerRole.code
SHOULD
0..*
PractitionerRole.code.coding
This SHOULD be populated when indicating the roles a practitioner can perform
SHOULD
1..1
PractitionerRole.code.coding.system
This MUST be populated with the CodeSystem from the ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode' - FIXED VALUE
SHOULD
0..1
https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode
PractitionerRole.code.coding.code
This MUST be populated with Code of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'.
SHOULD
0..1
224508005
PractitionerRole.code.coding.display
This MUST be populated with Display of CodeSystem value. See ValueSet 'https://fhir.hl7.org.uk/ValueSet/UKCore-PractitionerRoleCode'.
SHOULD
0..1
Administrative healthcare staff
The HealthcareService the request is being made of - Receiver. The HealthcareService resource is retrieved via the GET /Slot request and SHOULD be returned how it was received but MAY be added to. The Id value MUST remain the same. The details of a healthcare service available at a location The details of a healthcare service available at a location. Logical id of this artifact The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Metadata about the resource 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. A set of rules under which this content was created 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. 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. Language of the resource content The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Text summary of the resource, for human interpretation narrative, html, xhtml, display 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. 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. Contained, inline Resources inline resources, anonymous resources, contained resources 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. 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. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored extensions, user content 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. External identifiers for this item External identifiers for this item. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Whether this HealthcareService record is in active use This flag is used to mark the record to not be used. This is not used when a center is closed for maintenance, or for holidays, the notAvailable period is to be used for this. This element is labeled as a modifier because it may be used to mark that the resource was created in error. This resource is generally assumed to be active if no value is provided for the active element Organization that provides this service The organization that provides this healthcare service. This property is recommended to be the same as the Location's managingOrganization, and if not provided should be interpreted as such. If the Location does not have a managing Organization, then this property should be populated. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Broad category of service being performed or delivered service category Identifies the broad category of service being performed or delivered. Selecting a Service Category then determines the list of relevant service types that can be selected in the primary service type. A category of the service(s) that could be provided. Type of service that may be delivered or performed service type The specific type of service that may be delivered or performed. Additional details about where the content was created (e.g. clinical specialty). Specialties handled by the HealthcareService Collection of specialties handled by the service site. This is more of a medical term. A specialty that a healthcare service may provide. Location(s) where service may be provided The location(s) where this healthcare service may be provided. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Description of service as presented to a consumer while searching Further description of the service as it would be presented to a consumer while searching. Additional description and/or any specific issues not covered elsewhere Any additional description of the service and/or any specific issues not covered by the other attributes, which can be displayed as further detail under the serviceName. Would expect that a user would not see this information on a search results, and it would only be available when viewing the complete details of the service. Extra details about the service that can't be placed in the other fields Extra details about the service that can't be placed in the other fields. Facilitates quick identification of the service If there is a photo/symbol associated with this HealthcareService, it may be included here to facilitate quick identification of the service in a list. Contacts related to the healthcare service List of contacts related to this specific healthcare service. If this is empty, then refer to the location's contacts. Location(s) service is intended for/available to The location(s) that this service is available to (not where the service is provided). The locations referenced by the coverage area can include both specific locations, including areas, and also conceptual domains too (mode = kind), such as a physical area (tri-state area) and some other attribute (covered by Example Care Organization). These types of Locations are often not managed by any specific organization. This could also include generic locations such as "in-home". Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. Conditions under which service is available/offered The code(s) that detail the conditions under which the healthcare service is available/offered. The provision means being commissioned by, contractually obliged or financially sourced. Types of costings that may apply to this healthcare service, such if the service may be available for free, some discounts available, or fees apply. The code(s) that detail the conditions under which the healthcare service is available/offered. Specific eligibility requirements required to use the service Does this service have specific eligibility requirements that need to be met in order to use the service? Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Coded value for the eligibility Coded value for the eligibility. Coded values underwhich a specific service is made available. Describes the eligibility conditions for the service Describes the eligibility conditions for the service. The description of service eligibility should, in general, not exceed one or two paragraphs. It should be sufficient for a prospective consumer to determine if they are likely to be eligible or not. Where eligibility requirements and conditions are complex, it may simply be noted that an eligibility assessment is required. Where eligibility is determined by an outside source, such as an Act of Parliament, this should be noted, preferably with a reference to a commonly available copy of the source document such as a web page. Programs that this service is applicable to Programs that this service is applicable to. Programs are often defined externally to an Organization, commonly by governments; e.g. Home and Community Care Programs, Homeless Program, …. Government or local programs that this service applies to. Collection of characteristics (attributes) Collection of characteristics (attributes). These could be such things as is wheelchair accessible. A custom attribute that could be provided at a service (e.g. Wheelchair accessibiliy). The language that this service is offered in Some services are specifically made available in multiple languages, this property permits a directory to declare the languages this is offered in. Typically this is only provided where a service operates in communities with mixed languages used. When using this property it indicates that the service is available with this language, it is not derived from the practitioners, and not all are required to use this language, just that this language is available while scheduling. A ValueSet that identifies the language used by a person. Ways that the service accepts referrals Ways that the service accepts referrals, if this is not provided then it is implied that no referral is required. The methods of referral can be used when referring to a specific HealthCareService resource. If an appointment is required for access to this service Indicates whether or not a prospective consumer will require an appointment for a particular service at a site to be provided by the Organization. Indicates if an appointment is required for access to this service. Times the Service Site is available A collection of times that the Service Site is available. More detailed availability information may be provided in associated Schedule/Slot resources. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. mon | tue | wed | thu | fri | sat | sun Indicates which days of the week are available between the start and end Times. The days of the week. Always available? e.g. 24 hour service Is this always available? (hence times are irrelevant) e.g. 24 hour service. Opening time of day (ignored if allDay = true) The opening time of day. Note: If the AllDay flag is set, then this time is ignored. The time zone is expected to be for where this HealthcareService is provided at. Closing time of day (ignored if allDay = true) The closing time of day. Note: If the AllDay flag is set, then this time is ignored. The time zone is expected to be for where this HealthcareService is provided at. Not available during this time due to provided reason The HealthcareService is not available during this period of time due to the provided reason. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. 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. Extensions that cannot be ignored even if unrecognized extensions, user content, modifiers 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). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Reason presented to the user explaining why time not available The reason that can be presented to the user as to why this time is not available. Service not available from this date Service is not available (seasonally or for a public holiday) from this date. Description of availability exceptions 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. Technical endpoints providing access to electronic services operated for the healthcare service Technical endpoints providing access to services operated for the specific healthcare services defined at this resource. Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Literal reference, Relative, internal or absolute URL A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. Type the reference refers to (e.g. "Patient") The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model). Logical reference, when literal reference is not known An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). Unique id for inter-element referencing Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Additional content defined by implementations extensions, user content 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. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) usual | official | temp | secondary | old (If known) The purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . Description of identifier A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. The namespace for the identifier value Establishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive. The value that is unique The portion of the identifier typically relevant to the user and which is unique within the context of the system. 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. Time period when id is/was valid for use Time period during which identifier is/was valid for use. Organization that issued id (may be just text) Organization that issued/manages the identifier. 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. Text alternative for the resource Plain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.> Healthcare Service
UKCoreHealthcareService (HealthcareService) I HealthcareService HealthcareService
contained.contained.empty()
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()
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
contained.meta.security.empty()
text.`div`.exists()
id Σ 0..1 string HealthcareService.id
meta Σ 0..1 Meta HealthcareService.meta
hasValue() or (children().count() > id.count())
implicitRules Σ ?! 0..1 uri HealthcareService.implicitRules
hasValue() or (children().count() > id.count())
language 0..1 codeBinding HealthcareService.language
hasValue() or (children().count() > id.count())
text 0..1 Narrative HealthcareService.text
hasValue() or (children().count() > id.count())
contained 0..* Resource HealthcareService.contained
extension I 0..* Extension HealthcareService.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension ?! I 0..* Extension HealthcareService.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
identifier Σ 0..* Identifier HealthcareService.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.identifier.id
extension I 0..* Extension HealthcareService.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.identifier.assigner
hasValue() or (children().count() > id.count())
active Σ ?! 0..1 boolean HealthcareService.active
hasValue() or (children().count() > id.count())
providedBy Σ 0..1 Reference() Element id HealthcareService.providedBy
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.providedBy.id
extension I 0..* Extension HealthcareService.providedBy.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string HealthcareService.providedBy.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding HealthcareService.providedBy.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier HealthcareService.providedBy.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.providedBy.identifier.id
extension I 0..* Extension HealthcareService.providedBy.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.providedBy.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.providedBy.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.providedBy.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.providedBy.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.providedBy.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.providedBy.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string HealthcareService.providedBy.display
hasValue() or (children().count() > id.count())
category Σ 0..* CodeableConcept HealthcareService.category
hasValue() or (children().count() > id.count())
type Σ 0..* CodeableConcept HealthcareService.type
hasValue() or (children().count() > id.count())
specialty Σ 0..* CodeableConceptBinding HealthcareService.specialty
hasValue() or (children().count() > id.count())
location Σ 0..* Reference() Element id HealthcareService.location
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.location.id
extension I 0..* Extension HealthcareService.location.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string HealthcareService.location.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding HealthcareService.location.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier HealthcareService.location.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.location.identifier.id
extension I 0..* Extension HealthcareService.location.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.location.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.location.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.location.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.location.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.location.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.location.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string HealthcareService.location.display
hasValue() or (children().count() > id.count())
name Σ 0..1 string HealthcareService.name
hasValue() or (children().count() > id.count())
comment Σ 0..1 string HealthcareService.comment
hasValue() or (children().count() > id.count())
extraDetails 0..1 markdown HealthcareService.extraDetails
hasValue() or (children().count() > id.count())
photo Σ 0..1 Attachment HealthcareService.photo
hasValue() or (children().count() > id.count())
telecom 0..* ContactPoint HealthcareService.telecom
hasValue() or (children().count() > id.count())
coverageArea 0..* Reference() Element id HealthcareService.coverageArea
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.coverageArea.id
extension I 0..* Extension HealthcareService.coverageArea.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string HealthcareService.coverageArea.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding HealthcareService.coverageArea.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier HealthcareService.coverageArea.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.coverageArea.identifier.id
extension I 0..* Extension HealthcareService.coverageArea.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.coverageArea.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.coverageArea.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.coverageArea.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.coverageArea.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.coverageArea.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.coverageArea.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string HealthcareService.coverageArea.display
hasValue() or (children().count() > id.count())
serviceProvisionCode 0..* CodeableConcept HealthcareService.serviceProvisionCode
hasValue() or (children().count() > id.count())
eligibility 0..* BackboneElement HealthcareService.eligibility
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.eligibility.id
extension I 0..* Extension HealthcareService.eligibility.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension HealthcareService.eligibility.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
code 0..1 CodeableConcept HealthcareService.eligibility.code
hasValue() or (children().count() > id.count())
comment 0..1 markdown HealthcareService.eligibility.comment
hasValue() or (children().count() > id.count())
program 0..* CodeableConcept HealthcareService.program
hasValue() or (children().count() > id.count())
characteristic 0..* CodeableConcept HealthcareService.characteristic
hasValue() or (children().count() > id.count())
communication 0..* CodeableConceptBinding Element id HealthcareService.communication
hasValue() or (children().count() > id.count())
referralMethod 0..* CodeableConcept HealthcareService.referralMethod
hasValue() or (children().count() > id.count())
appointmentRequired 0..1 boolean HealthcareService.appointmentRequired
hasValue() or (children().count() > id.count())
availableTime 0..* BackboneElement HealthcareService.availableTime
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.availableTime.id
extension I 0..* Extension HealthcareService.availableTime.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension HealthcareService.availableTime.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
daysOfWeek 0..* codeBinding HealthcareService.availableTime.daysOfWeek
hasValue() or (children().count() > id.count())
allDay 0..1 boolean HealthcareService.availableTime.allDay
hasValue() or (children().count() > id.count())
availableStartTime 0..1 time HealthcareService.availableTime.availableStartTime
hasValue() or (children().count() > id.count())
availableEndTime 0..1 time HealthcareService.availableTime.availableEndTime
hasValue() or (children().count() > id.count())
notAvailable 0..* BackboneElement HealthcareService.notAvailable
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.notAvailable.id
extension I 0..* Extension HealthcareService.notAvailable.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
modifierExtension Σ ?! I 0..* Extension HealthcareService.notAvailable.modifierExtension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
description 1..1 string HealthcareService.notAvailable.description
hasValue() or (children().count() > id.count())
during 0..1 Period HealthcareService.notAvailable.during
hasValue() or (children().count() > id.count())
availabilityExceptions 0..1 string HealthcareService.availabilityExceptions
hasValue() or (children().count() > id.count())
endpoint 0..* Reference(Endpoint) HealthcareService.endpoint
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.endpoint.id
extension I 0..* Extension HealthcareService.endpoint.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
reference Σ I 0..1 string HealthcareService.endpoint.reference
hasValue() or (children().count() > id.count())
type Σ 0..1 uriBinding HealthcareService.endpoint.type
hasValue() or (children().count() > id.count())
identifier Σ 0..1 Identifier HealthcareService.endpoint.identifier
hasValue() or (children().count() > id.count())
id 0..1 string HealthcareService.endpoint.identifier.id
extension I 0..* Extension HealthcareService.endpoint.identifier.extension
hasValue() or (children().count() > id.count())
extension.exists() != value.exists()
use Σ ?! 0..1 codeBinding HealthcareService.endpoint.identifier.use
hasValue() or (children().count() > id.count())
type Σ 0..1 CodeableConceptBinding HealthcareService.endpoint.identifier.type
hasValue() or (children().count() > id.count())
system Σ 0..1 uri HealthcareService.endpoint.identifier.system
hasValue() or (children().count() > id.count())
http://www.acme.com/identifiers/patient
Mappingsvalue Σ 0..1 string HealthcareService.endpoint.identifier.value
hasValue() or (children().count() > id.count())
123456
Mappingsperiod Σ 0..1 Period HealthcareService.endpoint.identifier.period
hasValue() or (children().count() > id.count())
assigner Σ 0..1 Reference() Element id HealthcareService.endpoint.identifier.assigner
hasValue() or (children().count() > id.count())
display Σ 0..1 string HealthcareService.endpoint.display
hasValue() or (children().count() > id.count())
Data Item
Implementation Guidance
Necessity
Cadinality UKCore
Example Value(s)
HealthcareService
https://simplifier.net/hl7fhirukcorer4/ukcore-healthcareservice
1..1
HealthcareService.id
This MUST be populated with the value retrieved for the resource via the GET /Sot request.
MUST
1..1
1801e180-e6a1-4753-8a55-ab2d1cff6549
HealthcareService.meta
https://www.hl7.org/fhir/resource.html#Meta
MUST
1..1
HealthcareService.meta.profile
This MUST be populated. Follow UK Core guidance for populating this element
MUST
1..1
https://fhir.hl7.org.uk/StructureDefinition/UKCore-HealthcareService
HealthcareService.meta.lastUpdated
This MUST be populated. All resources MUST include 'lastUpdated' value, under meta section which MUST be the same timestamp for each resource when created from new, but MUST be a later timestamp on updates, if the content of a particular resource contains updated info for subsequent updates. Otherwise, maintain the timestamp originally sent.
MUST
1..1
2023-03-08T12:01:08.4677672+00:00
HealthcareService.identifier
MUST
0..*
HealthcareService.identifier.system
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
https://system.supplier.co.uk/My/Healthcare/Services
HealthcareService.identifier.value
This MUST be populated with the receiving HealthcareService identifier e.g ODS code
MUST
0..1
100
HealthcareService.active
This MUST be populated. Follow UK Core guidance for populating this element
MUST
HealthcareService.providedBy
This MUST be populated. Follow UK Core guidance for populating this element
MUST
HealthcareService.providedBy.reference
link to the Organisation the request is being made of
MUST
HealthcareService.location
MAY
0..*
HealthcareService.location.reference
Follow UK Core guidance for populating this element
MAY
0..1
urn:uuid:860e4c37-4e36-45fb-8fca-41132cd937a5
HealthcareService.name
This MUST be populated. Follow UK Core guidance for populating this element
MUST
0..1
Healthcare Service Name