PFS Appointments

This guidance is under active development by NHS Digital and content may be added or updated on a regular basis.
Note: This is a draft version of the GP Connect PFS Appointments capability. The current version can be found using this link.

Profile: GPConnect-OperationOutcome-1

severityΣ ?!1..1codeBinding
codeΣ1..1codeBinding
systemΣ1..1uriFixed Value
versionΣ0..0string
codeΣ1..1code
displayΣ1..1string
userSelectedΣ0..0boolean
textΣ0..1string
diagnosticsΣ0..1string
locationΣ0..*string
expressionΣ0..*string
OperationOutcome
DefinitionA collection of error, warning or information messages that result from a system action.
Cardinality0...*
Comments

Can result from the failure of a REST call or be part of the response message returned from a request message. If sent with extensions overriding particular issues, might even appear as part of a request message.

Invariants
  • dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1:If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4:If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3:If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
Mappings
  • rim:Entity. Role, or Act
  • rim:Grouping is handled through multiple repetitions from whatever context references the outcomes (no specific grouper required)
  • w5:infrastructure.exchange
OperationOutcome.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
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.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
OperationOutcome.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
OperationOutcome.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
OperationOutcome.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding

A human language.

Common Languages (extensible)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
OperationOutcome.text
DefinitionA human-readable narrative that contains a summary of the resource, and may 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.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • rim:N/A
  • rim:Act.text?
OperationOutcome.contained
DefinitionThese 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.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Mappings
  • rim:Entity. Role, or Act
  • rim:N/A
OperationOutcome.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
OperationOutcome.modifierExtension
DefinitionMay 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. Usually modifier elements provide negation or qualification. In order to make the 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.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
OperationOutcome.issue
DefinitionAn error, warning or information message that results from a system action.
Cardinality1...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:ERR
  • rim:AcknowledgementDetail or Observation[classCode="ALRT" and moodCode="EVN"]
OperationOutcome.issue.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
OperationOutcome.issue.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
OperationOutcome.issue.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the 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.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
OperationOutcome.issue.severity
DefinitionIndicates whether the issue indicates a variation from successful processing.
Cardinality1...1
Typecode
Binding

How the issue affects the success of the action.

IssueSeverity (required)
ModifierTrue
SummaryTrue
Requirements

Indicates how relevant the issue is to the overall success of the action.

Comments

This is labeled as "Is Modifier" because applications should not confuse hints and warnings with errors.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:ERR-4
  • rim:./typeCode[parent::AcknowledgmentDetail] or unique(./inboundRelationship[parent::Observation and typeCode='SUBJ' and isNormalActRelationship()]/source[classCode="OBS" and moodCode="EVN" and implies(code, ActCode#SEV and isNormalAct())/value[xsi:type="CD"]
OperationOutcome.issue.code
DefinitionDescribes the type of the issue. The system that creates an OperationOutcome SHALL choose the most applicable code from the IssueType value set, and may additional provide its own code for the error in the details element.
Cardinality1...1
Typecode
Binding

A code that describes the type of issue.

IssueType (required)
SummaryTrue
Requirements

Expresses the issue in a human and computer-friendly way, allowing the requesting system to behave differently based on the type of issue.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:ERR-3
  • rim:./code
OperationOutcome.issue.details
DefinitionAdditional details about the error. This may be a text description of the error, or a system code that identifies the error.
Cardinality1...1
TypeCodeableConcept
Binding

The Spine error or warning code in response to a request

Spine Error Or Warning Code (required)
SummaryTrue
Comments

A human readable description of the error issue SHOULD be placed in details.text.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE
  • rim:CD
  • orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2:ERR-5
  • rim:./code
OperationOutcome.issue.details.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
OperationOutcome.issue.details.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
OperationOutcome.issue.details.coding
DefinitionA reference to a code defined by a terminology system.
Cardinality1...1
TypeCoding
SummaryTrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim:CV
  • orim:fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2:C*E.1-8, C*E.10-22
  • rim:union(., ./translation)
  • orim:fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
OperationOutcome.issue.details.coding.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
OperationOutcome.issue.details.coding.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the 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.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1:Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim:n/a
  • rim:N/A
OperationOutcome.issue.details.coding.system
DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Cardinality1...1
Typeuri
SummaryTrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Fixed Value

https://fhir.nhs.uk/STU3/CodeSystem/Spine-ErrorOrWarningCode-1

Mappings
  • rim:n/a
  • v2:C*E.3
  • rim:./codeSystem
  • orim:fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
OperationOutcome.issue.details.coding.version
DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Cardinality0...0
Typestring
SummaryTrue
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.7
  • rim:./codeSystemVersion
  • orim:fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
OperationOutcome.issue.details.coding.code
DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Cardinality1...1
Typecode
SummaryTrue
Requirements

Need to refer to a particular code in the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.1
  • rim:./code
  • orim:fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
OperationOutcome.issue.details.coding.display
DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Cardinality1...1
Typestring
SummaryTrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.2 - but note this is not well followed
  • rim:CV.displayName
  • orim:fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
OperationOutcome.issue.details.coding.userSelected
DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
Cardinality0...0
Typeboolean
SummaryTrue
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:Sometimes implied by being first
  • rim:CD.codingRationale
  • orim:fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
OperationOutcome.issue.details.text
DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Cardinality0...1
Typestring
SummaryTrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:C*E.9. But note many systems use C*E.2 for this
  • rim:./originalText[mediaType/code="text/plain"]/data
  • orim:fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
OperationOutcome.issue.diagnostics
DefinitionAdditional diagnostic information about the issue. Typically, this may be a description of how a value is erroneous, or a stack dump to help trace the issue.
Cardinality0...1
Typestring
SummaryTrue
Comments

Typically this field is used to provide troubleshooting information about the error.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:ERR-8
  • rim:./text[parent::AcknowledgmentDetail]
OperationOutcome.issue.location
DefinitionFor resource issues, this will be a simple XPath limited to element names, repetition indicators and the default child access that identifies one of the elements in the resource that caused this issue to be raised. For HTTP errors, will be "http." + the parameter name.
Cardinality0...*
Typestring
SummaryTrue
Requirements

Allows systems to highlight or otherwise guide users to elements implicated in issues to allow them to be fixed more easily.

Comments

The root of the XPath is the resource or bundle that generated OperationOutcome. Each XPath SHALL resolve to a single node. The XPath syntax is used whether the referenced instance is expressed in XML or JSON. Note that expression is being trialed as an alternative to XPath.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:ERR-2
  • rim:./location[parent::AcknowledgmentDetail]
OperationOutcome.issue.expression
DefinitionA simple FHIRPath limited to element names, repetition indicators and the default child access that identifies one of the elements in the resource that caused this issue to be raised.
Cardinality0...*
Typestring
SummaryTrue
Requirements

Allows systems to highlight or otherwise guide users to elements implicated in issues to allow them to be fixed more easily.

Comments

The root of the FHIRPath is the resource or bundle that generated OperationOutcome. Each FHIRPath SHALL resolve to a single node.

Invariants
  • ele-1:All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim:n/a
  • v2:ERR-2
  • rim:./location[parent::AcknowledgmentDetail]
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