Pan-Canadian eReferral-eConsult (CA:eReC) v1.1.0-DFT-Ballot

preBallot - The specification is currently in ballot review and subject to change. . . . For a full list of available versions, see the Directory of published versions

Communication (CA:eReC)

Description

Communication resource is used to achieve the bi-directional communication between two systems. The Communication resource can be used to ask questions regarding a referral, request a referral be updated with missing information, or request additional information not covered by the specific referral dataset.

References to this resource

MessageHeader, ServiceRequest, Task

Resource Content

Communication			Communication	There are no (further) constraints on this element Data type Communication
basedOn	S	1..1	Reference(ServiceRequest)	There are no (further) constraints on this element Element id Communication.basedOn Data type Reference(ServiceRequest)
reference	S			There are no (further) constraints on this element Element id Communication.basedOn.reference
identifier	S			There are no (further) constraints on this element Element id Communication.basedOn.identifier
use	S	1..		There are no (further) constraints on this element Element id Communication.basedOn.identifier.use
system	S	1..		There are no (further) constraints on this element Element id Communication.basedOn.identifier.system
value	S	1..		There are no (further) constraints on this element Element id Communication.basedOn.identifier.value
inResponseTo	S			There are no (further) constraints on this element Element id Communication.inResponseTo
status	S		BindingFixed Value	There are no (further) constraints on this element Element id Communication.status Binding EventStatus (required) Fixed value completed
category	S			There are no (further) constraints on this element Element id Communication.category Binding CommunicationCategory (example)
subject	S		Reference(Patient)	There are no (further) constraints on this element Element id Communication.subject Data type Reference(Patient)
reference	S			There are no (further) constraints on this element Element id Communication.subject.reference
identifier	S			There are no (further) constraints on this element Element id Communication.subject.identifier
system	S	1..		There are no (further) constraints on this element Element id Communication.subject.identifier.system
value	S	1..		There are no (further) constraints on this element Element id Communication.subject.identifier.value
sent	S			There are no (further) constraints on this element Element id Communication.sent
received	S			There are no (further) constraints on this element Element id Communication.received
sender	S		Reference(PractitionerRole \| HealthcareService)	There are no (further) constraints on this element Element id Communication.sender Comments When the communication comes from a CAT, then HealthcareService can be used to identify the sender. Data type Reference(PractitionerRole \| HealthcareService)
reference	S			There are no (further) constraints on this element Element id Communication.sender.reference
identifier	S			There are no (further) constraints on this element Element id Communication.sender.identifier
system	S	1..		There are no (further) constraints on this element Element id Communication.sender.identifier.system
value	S	1..		There are no (further) constraints on this element Element id Communication.sender.identifier.value
payload	S			There are no (further) constraints on this element Element id Communication.payload
content[x]	S			There are no (further) constraints on this element Element id Communication.payload.content[x]
contentString			string	There are no (further) constraints on this element Data type string
contentAttachment			Attachment	There are no (further) constraints on this element Data type Attachment

Communication	I		Communication	There are no (further) constraints on this element Element id Communication Short description A record of information transmitted from a sender to a receiver Definition An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency that was notified about a reportable condition. Data type Communication Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Event
id	Σ	0..1	string	There are no (further) constraints on this element Element id Communication.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	Σ	0..1	Meta	There are no (further) constraints on this element Element id Communication.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Communication.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id Communication.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id Communication.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Communication.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Communication.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Communication.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Communication.identifier Short description Unique identifier Definition Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server. Requirements Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers. Comments 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. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.identifier w5: FiveWs.identifier
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire)	There are no (further) constraints on this element Element id Communication.instantiatesCanonical Short description Instantiates FHIR protocol or definition 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 Communication. Data type canonical(PlanDefinition \| ActivityDefinition \| Measure \| OperationDefinition \| Questionnaire) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.instantiatesCanonical rim: .outboundRelationship[typeCode=DEFN].target
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element id Communication.instantiatesUri Short description Instantiates external protocol or definition 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 Communication. Comments This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.instantiatesUri rim: .outboundRelationship[typeCode=DEFN].target
basedOn	S Σ	1..1	Reference(ServiceRequest)	Element id Communication.basedOn Short description Request fulfilled by this communication Alternate names fulfills Definition An order, proposal or plan fulfilled in whole or in part by this Communication. Comments This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc. Data type Reference(ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.basedOn
id		0..1	string	There are no (further) constraints on this element Element id Communication.basedOn.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Communication.basedOn.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	0..1	string	There are no (further) constraints on this element Element id Communication.basedOn.reference Short description Literal reference, Relative, internal or absolute URL Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Communication.basedOn.type Short description Type the reference refers to (e.g. "Patient") Definition 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	S Σ	0..1	Identifier	There are no (further) constraints on this element Element id Communication.basedOn.identifier Short description Logical reference, when literal reference is not known Definition 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
id		0..1	string	There are no (further) constraints on this element Element id Communication.basedOn.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Communication.basedOn.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	S Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Communication.basedOn.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Communication.basedOn.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	1..1	uri	There are no (further) constraints on this element Element id Communication.basedOn.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Communication.basedOn.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Communication.basedOn.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Communication.basedOn.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
display	Σ	0..1	string	There are no (further) constraints on this element Element id Communication.basedOn.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
partOf	Σ	0..*	Reference(Resource)	There are no (further) constraints on this element Element id Communication.partOf Short description Part of this action Alternate names container Definition Part of this action. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.partOf
inResponseTo	S	0..*	Reference(Communication)	There are no (further) constraints on this element Element id Communication.inResponseTo Short description Reply to Definition Prior communication that this communication is in response to. Data type Reference(Communication) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
status	S Σ ?!	1..1	codeBindingFixed Value	Element id Communication.status Short description preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown Definition The status of the transmission. Comments This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid. Data type code Binding The status of the communication. EventStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Fixed value completed Mappings workflow: Event.status w5: FiveWs.status
statusReason	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Communication.statusReason Short description Reason for current status Alternate names Suspended Reason, Cancelled Reason Definition Captures the reason for the current state of the Communication. Comments This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here. Data type CodeableConcept Binding Codes for the reason why a communication did not happen. CommunicationNotDoneReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.statusReason
category	S	0..*	CodeableConcept	Element id Communication.category Short description Message category Definition The type of message conveyed such as alert, notification, reminder, instruction, etc. Comments There may be multiple axes of categorization and one communication may serve multiple purposes. Data type CodeableConcept Binding Codes for general categories of communications such as alerts, instructions, etc. CommunicationCategory (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.class
priority	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Communication.priority Short description routine \| urgent \| asap \| stat Definition Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine. Comments Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress. Meaning when missing If missing, this communication should be treated with normal priority Data type code Binding Codes indicating the relative importance of a communication. RequestPriority (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.grade
medium		0..*	CodeableConcept	There are no (further) constraints on this element Element id Communication.medium Short description A channel of communication Definition A channel that was used for this communication (e.g. email, fax). Data type CodeableConcept Binding Codes for communication mediums such as phone, fax, email, in person, etc. v3.ParticipationMode (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
subject	S Σ	0..1	Reference(Patient)	Element id Communication.subject Short description Focus of message Alternate names patient Definition The patient or group that was the focus of this communication. Data type Reference(Patient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.subject w5: FiveWs.subject[x] w5: FiveWs.subject
id		0..1	string	There are no (further) constraints on this element Element id Communication.subject.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Communication.subject.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	0..1	string	There are no (further) constraints on this element Element id Communication.subject.reference Short description Literal reference, Relative, internal or absolute URL Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Communication.subject.type Short description Type the reference refers to (e.g. "Patient") Definition 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	S Σ	0..1	Identifier	There are no (further) constraints on this element Element id Communication.subject.identifier Short description Logical reference, when literal reference is not known Definition 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
id		0..1	string	There are no (further) constraints on this element Element id Communication.subject.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Communication.subject.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Communication.subject.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Communication.subject.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	1..1	uri	There are no (further) constraints on this element Element id Communication.subject.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Communication.subject.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Communication.subject.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Communication.subject.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
display	Σ	0..1	string	There are no (further) constraints on this element Element id Communication.subject.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
topic		0..1	CodeableConcept	There are no (further) constraints on this element Element id Communication.topic Short description Description of the purpose/content Definition Description of the purpose/content, similar to a subject line in an email. Comments Communication.topic.text can be used without any codings. Data type CodeableConcept Binding Codes describing the purpose or content of the communication. CommunicationTopic (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.context
about		0..*	Reference(Resource)	There are no (further) constraints on this element Element id Communication.about Short description Resources that pertain to this communication Definition Other resources that pertain to this communication and to which this communication should be associated. Comments Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings w5: FiveWs.context
encounter	Σ	0..1	Reference(Encounter)	There are no (further) constraints on this element Element id Communication.encounter Short description Encounter created as part of Definition The Encounter during which this Communication was created or to which the creation of this record is tightly associated. Comments 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. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.context w5: FiveWs.context
sent	S	0..1	dateTime	There are no (further) constraints on this element Element id Communication.sent Short description When sent Definition The time when this communication was sent. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] {Invariant: maps to period.start} w5: FiveWs.done[x]
received	S	0..1	dateTime	There are no (further) constraints on this element Element id Communication.received Short description When received Definition The time when this communication arrived at the destination. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.occurrence[x] {Invariant: maps to period.end} w5: FiveWs.done[x]
recipient		0..*	Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Group \| CareTeam \| HealthcareService)	There are no (further) constraints on this element Element id Communication.recipient Short description Message recipient Definition The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time). Data type Reference(Device \| Organization \| Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Group \| CareTeam \| HealthcareService) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor w5: FiveWs.actor
sender	S	0..1	Reference(PractitionerRole \| HealthcareService)	Element id Communication.sender Short description Message sender Definition The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication. Comments When the communication comes from a CAT, then HealthcareService can be used to identify the sender. Data type Reference(PractitionerRole \| HealthcareService) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.performer.actor w5: FiveWs.actor
id		0..1	string	There are no (further) constraints on this element Element id Communication.sender.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Communication.sender.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
reference	S Σ I	0..1	string	There are no (further) constraints on this element Element id Communication.sender.reference Short description Literal reference, Relative, internal or absolute URL Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Communication.sender.type Short description Type the reference refers to (e.g. "Patient") Definition 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
identifier	S Σ	0..1	Identifier	There are no (further) constraints on this element Element id Communication.sender.identifier Short description Logical reference, when literal reference is not known Definition 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: .identifier
id		0..1	string	There are no (further) constraints on this element Element id Communication.sender.identifier.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Communication.sender.identifier.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element id Communication.sender.identifier.use Short description usual \| official \| temp \| secondary \| old (If known) Definition The purpose of this identifier. Requirements Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Comments Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Data type code Binding Identifies the purpose for this identifier, if known . IdentifierUse (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: N/A rim: Role.code or implied by context
type	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Communication.sender.identifier.type Short description Description of identifier Definition A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Requirements Allows users to make use of identifiers when the identifier system is not known. Comments 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. Data type CodeableConcept Binding A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Identifier Type Codes (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.5 rim: Role.code or implied by context
system	S Σ	1..1	uri	There are no (further) constraints on this element Element id Communication.sender.identifier.system Short description The namespace for the identifier value Definition Establishes the namespace for the value - that is, a URL that describes a set values that are unique. Requirements There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Comments Identifier.system is always case sensitive. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General http://www.acme.com/identifiers/patient Mappings v2: CX.4 / EI-2-4 rim: II.root or Role.id.root servd: ./IdentifierType
value	S Σ	1..1	string	There are no (further) constraints on this element Element id Communication.sender.identifier.value Short description The value that is unique Definition The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General 123456 Mappings v2: CX.1 / EI.1 rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) servd: ./Value
period	Σ	0..1	Period	There are no (further) constraints on this element Element id Communication.sender.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.7 + CX.8 rim: Role.effectiveTime or implied by context servd: ./StartDate and ./EndDate
assigner	Σ	0..1	Reference(Organization)	There are no (further) constraints on this element Element id Communication.sender.identifier.assigner Short description Organization that issued id (may be just text) Definition Organization that issued/manages the identifier. Comments The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. Data type Reference(Organization) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings v2: CX.4 / (CX.4,CX.9,CX.10) rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper servd: ./IdentifierIssuingAuthority
display	Σ	0..1	string	There are no (further) constraints on this element Element id Communication.sender.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: N/A
reasonCode	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Communication.reasonCode Short description Indication for message Definition The reason or justification for the communication. Comments Textual reasons can be captured using reasonCode.text. Data type CodeableConcept Binding Codes for describing reasons for the occurrence of a communication. SNOMEDCTClinicalFindings (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonCode w5: FiveWs.why[x] rim: .reasonCode
reasonReference	Σ	0..*	Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference)	There are no (further) constraints on this element Element id Communication.reasonReference Short description Why was communication done? Definition Indicates another resource whose existence justifies this communication. Data type Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.reasonReference w5: FiveWs.why[x] rim: .outboundRelationship[typeCode=RSON].target
payload	S	0..*	BackboneElement	There are no (further) constraints on this element Element id Communication.payload Short description Message payload Definition Text, attachment(s), or resource(s) that was communicated to the recipient. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id Communication.payload.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Communication.payload.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Communication.payload.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: N/A
content[x]	S	1..1		There are no (further) constraints on this element Element id Communication.payload.content[x] Short description Message part content Definition A communicated content (or for multi-part communications, one portion of the communication). Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
contentString			string	Data type string
contentAttachment			Attachment	Data type Attachment
note		0..*	Annotation	There are no (further) constraints on this element Element id Communication.note Short description Comments made about the communication Definition Additional notes or commentary about the communication by the sender, receiver or other interested parties. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Event.note

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="CA-eReC-Communication" />
    <url value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Communication" />
    <name value="Communication" />
    <title value="Communication" />
    <status value="draft" />
    <description value="Communication resource is used to achieve the bi-directional communication between two systems. The Communication resource can be used to ask questions regarding a referral, request a referral be updated with missing information, or request additional information not covered by the specific referral dataset." />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="Communication" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Communication" />
    <derivation value="constraint" />
    <differential>
        <element id="Communication.basedOn">
            <path value="Communication.basedOn" />
            <min value="1" />
            <max value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ServiceRequest" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="Communication.basedOn.reference">
            <path value="Communication.basedOn.reference" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.basedOn.identifier">
            <path value="Communication.basedOn.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.basedOn.identifier.use">
            <path value="Communication.basedOn.identifier.use" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.basedOn.identifier.system">
            <path value="Communication.basedOn.identifier.system" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.basedOn.identifier.value">
            <path value="Communication.basedOn.identifier.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.inResponseTo">
            <path value="Communication.inResponseTo" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.status">
            <path value="Communication.status" />
            <fixedCode value="completed" />
            <mustSupport value="true" />
            <binding>
                <strength value="required" />
                <valueSet value="http://hl7.org/fhir/ValueSet/event-status" />
            </binding>
        </element>
        <element id="Communication.category">
            <path value="Communication.category" />
            <mustSupport value="true" />
            <binding>
                <strength value="example" />
                <valueSet value="http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-category" />
            </binding>
        </element>
        <element id="Communication.subject">
            <path value="Communication.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="Communication.subject.reference">
            <path value="Communication.subject.reference" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.subject.identifier">
            <path value="Communication.subject.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.subject.identifier.system">
            <path value="Communication.subject.identifier.system" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.subject.identifier.value">
            <path value="Communication.subject.identifier.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.sent">
            <path value="Communication.sent" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.received">
            <path value="Communication.received" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.sender">
            <path value="Communication.sender" />
            <comment value="When the communication comes from a CAT, then HealthcareService can be used to identify the sender." />
            <type>
                <code value="Reference" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-PractitionerRole" />
                <targetProfile value="http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-HealthcareService" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="Communication.sender.reference">
            <path value="Communication.sender.reference" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.sender.identifier">
            <path value="Communication.sender.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.sender.identifier.system">
            <path value="Communication.sender.identifier.system" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.sender.identifier.value">
            <path value="Communication.sender.identifier.value" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.payload">
            <path value="Communication.payload" />
            <mustSupport value="true" />
        </element>
        <element id="Communication.payload.content[x]">
            <path value="Communication.payload.content[x]" />
            <type>
                <code value="string" />
            </type>
            <type>
                <code value="Attachment" />
            </type>
            <mustSupport value="true" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "CA-eReC-Communication",
    "url": "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Communication",
    "name": "Communication",
    "title": "Communication",
    "status": "draft",
    "description": "Communication resource is used to achieve the bi-directional communication between two systems. The Communication resource can be used to ask questions regarding a referral, request a referral be updated with missing information, or request additional information not covered by the specific referral dataset.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Communication",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Communication",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Communication.basedOn",
                "path": "Communication.basedOn",
                "min": 1,
                "max": "1",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ServiceRequest"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Communication.basedOn.reference",
                "path": "Communication.basedOn.reference",
                "mustSupport": true
            },
            {
                "id": "Communication.basedOn.identifier",
                "path": "Communication.basedOn.identifier",
                "mustSupport": true
            },
            {
                "id": "Communication.basedOn.identifier.use",
                "path": "Communication.basedOn.identifier.use",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.basedOn.identifier.system",
                "path": "Communication.basedOn.identifier.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.basedOn.identifier.value",
                "path": "Communication.basedOn.identifier.value",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.inResponseTo",
                "path": "Communication.inResponseTo",
                "mustSupport": true
            },
            {
                "id": "Communication.status",
                "path": "Communication.status",
                "fixedCode": "completed",
                "mustSupport": true,
                "binding": {
                    "strength": "required",
                    "valueSet": "http://hl7.org/fhir/ValueSet/event-status"
                }
            },
            {
                "id": "Communication.category",
                "path": "Communication.category",
                "mustSupport": true,
                "binding": {
                    "strength": "example",
                    "valueSet": "http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-category"
                }
            },
            {
                "id": "Communication.subject",
                "path": "Communication.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Communication.subject.reference",
                "path": "Communication.subject.reference",
                "mustSupport": true
            },
            {
                "id": "Communication.subject.identifier",
                "path": "Communication.subject.identifier",
                "mustSupport": true
            },
            {
                "id": "Communication.subject.identifier.system",
                "path": "Communication.subject.identifier.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.subject.identifier.value",
                "path": "Communication.subject.identifier.value",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.sent",
                "path": "Communication.sent",
                "mustSupport": true
            },
            {
                "id": "Communication.received",
                "path": "Communication.received",
                "mustSupport": true
            },
            {
                "id": "Communication.sender",
                "path": "Communication.sender",
                "comment": "When the communication comes from a CAT, then HealthcareService can be used to identify the sender.",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-PractitionerRole",
                            "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-HealthcareService"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Communication.sender.reference",
                "path": "Communication.sender.reference",
                "mustSupport": true
            },
            {
                "id": "Communication.sender.identifier",
                "path": "Communication.sender.identifier",
                "mustSupport": true
            },
            {
                "id": "Communication.sender.identifier.system",
                "path": "Communication.sender.identifier.system",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.sender.identifier.value",
                "path": "Communication.sender.identifier.value",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "Communication.payload",
                "path": "Communication.payload",
                "mustSupport": true
            },
            {
                "id": "Communication.payload.content[x]",
                "path": "Communication.payload.content[x]",
                "type":  [
                    {
                        "code": "string"
                    },
                    {
                        "code": "Attachment"
                    }
                ],
                "mustSupport": true
            }
        ]
    }
}

Terminology bindings

Path	Conformance	ValueSet
Communication.status	required	http://hl7.org/fhir/ValueSet/event-status
Communication.category	example	http://fhir.infoway-inforoute.ca/io/CA-eReC/ValueSet/communication-category

Constraints

Path	Id	Grade	Details	Expression
Communication; Communication; Communication; Communication; Communication; Communication.meta; Communication.implicitRules; Communication.language; Communication.text; Communication.extension; Communication.extension; Communication.modifierExtension; Communication.modifierExtension; Communication.identifier; Communication.instantiatesCanonical; Communication.instantiatesUri; Communication.basedOn; Communication.basedOn.extension; Communication.basedOn.extension; Communication.basedOn.reference; Communication.basedOn.type; Communication.basedOn.identifier; Communication.basedOn.identifier.extension; Communication.basedOn.identifier.extension; Communication.basedOn.identifier.use; Communication.basedOn.identifier.type; Communication.basedOn.identifier.system; Communication.basedOn.identifier.value; Communication.basedOn.identifier.period; Communication.basedOn.identifier.assigner; Communication.basedOn.display; Communication.partOf; Communication.inResponseTo; Communication.status; Communication.statusReason; Communication.category; Communication.priority; Communication.medium; Communication.subject; Communication.subject.extension; Communication.subject.extension; Communication.subject.reference; Communication.subject.type; Communication.subject.identifier; Communication.subject.identifier.extension; Communication.subject.identifier.extension; Communication.subject.identifier.use; Communication.subject.identifier.type; Communication.subject.identifier.system; Communication.subject.identifier.value; Communication.subject.identifier.period; Communication.subject.identifier.assigner; Communication.subject.display; Communication.topic; Communication.about; Communication.encounter; Communication.sent; Communication.received; Communication.recipient; Communication.sender; Communication.sender.extension; Communication.sender.extension; Communication.sender.reference; Communication.sender.type; Communication.sender.identifier; Communication.sender.identifier.extension; Communication.sender.identifier.extension; Communication.sender.identifier.use; Communication.sender.identifier.type; Communication.sender.identifier.system; Communication.sender.identifier.value; Communication.sender.identifier.period; Communication.sender.identifier.assigner; Communication.sender.display; Communication.reasonCode; Communication.reasonReference; Communication.payload; Communication.payload.extension; Communication.payload.extension; Communication.payload.modifierExtension; Communication.payload.modifierExtension; Communication.payload.content[x]; Communication.note	dom-2; dom-3; dom-4; dom-5; dom-6; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ele-1; ext-1; ele-1; ext-1; ele-1; ele-1	error; error; error; error; warning; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error; error	If the resource is contained in another resource, it SHALL NOT contain nested Resources; If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource; If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated; If a resource is contained in another resource, it SHALL NOT have a security label; A resource should have narrative for robust management; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; Must have either extensions or value[x], not both; All FHIR elements must have a @value or children; All FHIR elements must have a @value or children	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(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); extension.exists() != value.exists(); hasValue() or (children().count() > id.count()); hasValue() or (children().count() > id.count())

Usage

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

Notes

.id

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

.identifier

MAY be populated to share business identifers used to reference this resource in subsequent messages
identifier.system and identifier.value SHALL be mustSupport whenever there is a reference or identifier present

.basedOn

used to associate the Communication with the ServiceRequest being performed
SHALL be populated with a reference to the ServiceRequest being performed
if the Communication is being transmitted via messaging, this element SHALL be populated with either:
- a .reference to a resource included in the message as a Bundle.entry, or
- an .identifier populated with the use, system and value elements populated with the official ServiceRequest.identifier received from the Source System

inResponseTo

Where a Communication in MessageHeader.focus is part of a conversation, this element points to a Communication resource containing the question or comment the user is responding to
In these casses, the reference:
- SHALL be populated with a reference to the prior Communication
- the referended a resource SHALL be included in the message as a Bundle.entry
Including both the Communication in MessageHeader.focus and the one it is .inResponseTo as Bundle entries allows a the system receiving the message to correctly associate with one another on the receiving system
Other Communications further up the chain MAY be omitted on the assumption that any necessary associations between Communications have already been made
See L3: Communications for more information on responding to communications received.

.status

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

.category

Used to indicate the category of Communication
Use of values
- "gen" when sending general communications
- "plan" when sending plan of care on service completion
- "rfi" when sending a request for information

.subject

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

.sent

Populate with the time when the Communication was sent

.received

Populate with the time when the Communication was received
SHALL NOT be populated in the Communication in MessageHeader.focus on the "add-communication" event

.sender

Used to identify the person who sent the messaging (e.g.: when rendering a conversation between individuals for display in the receiving system)
SHALL be populated with a reference to the PractitionerRole of the person sending the communication
If the Communication is being transmitted via messaging, this element SHALL either:
- .reference a resource included in the message as a Bundle.entry, or
- include an .identifier previously known to both systems

.payload.content

The content of the Communication
Business rules:
- There SHALL NOT be more than one instance of .payload.contentString per Communication instance
- There MAY be multiple instances of .payload.contentAttachment per Communication instance
Expected use:
- When sending JUST a text message, send a single .payload.contentString
- When sending JUST attachments, send one .payload.contentAttachment for each attachment
- When sending a text message with attachments, send multiple instances of .payload
  - one with the message (.payload.contentString)
  - one for each attachment (.payload.contentAttachment)

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