Pan-Canadian Patient Summary (PS-CA) v2.1.0 DFT
2.1.0-DFT 
DFT - For a full list of available versions, see the Directory of published versions
Practitioner-Lab (PS-CA)
Links
Profile
Derived from
http://hl7.org/fhir/StructureDefinition/Practitioner
Examples
Description
This profile represents the constraints applied to the Practitioner resource by the PS-CA project to represent a practitioner acting as observer for diagnostic results. It is informed by the constraints of the Practitioner IPS-UV profile and the Canadian Baseline Profile to allow for cross-border and cross-jurisdiction sharing of details that support Diagnostic Result Information. This profile may be underpinned by a CA Core profile in the future. There is a possibility it will be replaced entirely by a CA Core profile if the requirements for use in lab are aligned to expectations for generic use.
References to this resource
DiagnosticReportPSCA, ObservationResultsLaboratoryPathologyPSCA, ObservationResultsRadiologyPSCA, PractitionerRoleLabPSCA
Resource Content
| PractitionerLabPSCA (Practitioner) | C | Practitioner | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| active | Σ | 0..1 | boolean |
| name | S Σ C | 1..* | HumanName |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| use | Σ ?! | 0..1 | codeBinding |
| text | Σ | 0..1 | string |
| family | S Σ | 0..1 | string |
| given | S Σ | 0..* | string |
| prefix | Σ | 0..* | string |
| suffix | Σ | 0..* | string |
| period | Σ | 0..1 | Period |
| telecom | Σ | 0..* | ContactPoint |
| address | Σ | 0..* | Address |
| gender | Σ | 0..1 | codeBinding |
| birthDate | Σ | 0..1 | date |
| photo | 0..* | Attachment | |
| qualification | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| identifier | 0..* | Identifier | |
| code | 1..1 | CodeableConcept | |
| period | 0..1 | Period | |
| issuer | 0..1 | Reference(Organization) | |
| communication | 0..* | CodeableConceptBinding |
| PractitionerLabPSCA (Practitioner) | C | Practitioner | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| active | Σ | 0..1 | boolean |
| name | S Σ C | 1..* | HumanName |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| use | Σ ?! | 0..1 | codeBinding |
| text | Σ | 0..1 | string |
| family | S Σ | 0..1 | string |
| given | S Σ | 0..* | string |
| prefix | Σ | 0..* | string |
| suffix | Σ | 0..* | string |
| period | Σ | 0..1 | Period |
| telecom | Σ | 0..* | ContactPoint |
| address | Σ | 0..* | Address |
| gender | Σ | 0..1 | codeBinding |
| birthDate | Σ | 0..1 | date |
| photo | 0..* | Attachment | |
| qualification | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| identifier | 0..* | Identifier | |
| code | 1..1 | CodeableConcept | |
| period | 0..1 | Period | |
| issuer | 0..1 | Reference(Organization) | |
| communication | 0..* | CodeableConceptBinding |
<description value="This profile represents the constraints applied to the Practitioner resource by the PS-CA project to represent a practitioner acting as observer for diagnostic results. It is informed by the constraints of the [Practitioner IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Practitioner-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-practitioner.html) to allow for cross-border and cross-jurisdiction sharing of details that support Diagnostic Result Information. This profile may be underpinned by a CA Core profile in the future. There is a possibility it will be replaced entirely by a CA Core profile if the requirements for use in lab are aligned to expectations for generic use." />
<copyright value="Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." />
<short value="A person with a formal responsibility in the provisioning of healthcare or related services" />
<definition value="A person who is directly or indirectly involved in the provisioning of healthcare." />
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="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" />
<expression value="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()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
</element>
<comment value="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)." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="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." />
<comment value="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." />
</base>
</type>
</mapping>
</element>
<definition value="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." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role." />
<requirements value="Need to be able to mark a practitioner record as not to be used because it was created in error." />
</base>
</type>
<meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the active element" />
</constraint>
</mapping>
</mapping>
</element>
<comment value="The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate. \n\nIn general, select the value to be used in the ResourceReference.display based on this:\n\n1. There is more than 1 name\n2. Use = usual\n3. Period is current to the date of the usage\n4. Use = official\n5. Other order as decided by internal business rules." />
<requirements value="The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display." />
</base>
</type>
</constraint>
<source value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/practitioner-lab-ca-ps" />
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<comment value="Applications can assume that a name is current unless it explicitly says that it is temporary or old." />
<requirements value="Allows the appropriate name for a particular context of use to be selected from among a set of names." />
</base>
</type>
</constraint>
<isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one" />
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts." />
<comment value="Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father." />
<comment value="Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<comment value="If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="A contact detail for the practitioner, e.g. a telephone number or an email address." />
<comment value="While IPS-UV considers Practitioner.telecom a Must Support element, a number of jurisdictional systems may not capture telecom for practitioner today, even in the scope of a practitioner that is the performer of an observation or diagnostic report. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
<requirements value="Need to know how to reach a practitioner independent to any roles the practitioner may have." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<short value="Address(es) of the practitioner that are not role specific (typically home address)" />
<definition value="Address(es) of the practitioner that are not role specific (typically home address). \nWork addresses are not typically entered in this property as they are usually role dependent." />
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
<requirements value="The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes." />
</base>
</type>
</constraint>
</extension>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<requirements value="Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="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](extensibility.html#modifierExtension)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</element>
<comment value="The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type." />
<requirements value="Knowing which language a practitioner speaks can help in facilitating communication with patients." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
</snapshot>
</constraint>
</element>
</element>
</element>
<comment value="While IPS-UV considers Practitioner.telecom a Must Support element, a number of jurisdictional systems may not capture telecom for practitioner today, even in the scope of a practitioner that is the performer of an observation or diagnostic report. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
</element>
<comment value="IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content." />
</element>
</differential>
</StructureDefinition>
{
"description": "This profile represents the constraints applied to the Practitioner resource by the PS-CA project to represent a practitioner acting as observer for diagnostic results. It is informed by the constraints of the [Practitioner IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Practitioner-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-practitioner.html) to allow for cross-border and cross-jurisdiction sharing of details that support Diagnostic Result Information. This profile may be underpinned by a CA Core profile in the future. There is a possibility it will be replaced entirely by a CA Core profile if the requirements for use in lab are aligned to expectations for generic use.",
"copyright": "Copyright © 2024+ Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy).",
{
"short": "A person with a formal responsibility in the provisioning of healthcare or related services",
},
{
},
{
"human": "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",
"expression": "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()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
},
{
{
},
{
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
},
{
{
}
],
}
],
},
{
"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.",
},
],
{
}
],
},
{
"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.",
"comment": "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.",
},
],
{
}
],
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
},
{
"comment": "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).",
},
],
{
}
],
{
},
{
},
{
}
],
}
},
{
"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.",
"comment": "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.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
{
}
],
]
},
{
"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.",
"comment": "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.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
"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.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
},
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"comment": "If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.",
"requirements": "Need to be able to mark a practitioner record as not to be used because it was created in error.",
},
],
"meaningWhenMissing": "This resource is generally assumed to be active if no value is provided for the active element",
{
}
],
]
},
{
"comment": "The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate. \n\nIn general, select the value to be used in the ResourceReference.display based on this:\n\n1. There is more than 1 name\n2. Use = usual\n3. Period is current to the date of the usage\n4. Use = official\n5. Other order as decided by internal business rules.",
"requirements": "The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.",
},
],
{
},
{
}
],
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"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.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"comment": "Applications can assume that a name is current unless it explicitly says that it is temporary or old.",
"requirements": "Allows the appropriate name for a particular context of use to be selected from among a set of names.",
},
],
{
}
],
"isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary or old name etc.for a current/permanent one",
{
}
],
},
{
},
{
},
{
}
]
},
{
"definition": "Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.",
"comment": "Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.",
},
],
{
}
],
]
},
{
"definition": "The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.",
"comment": "Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).",
"surname"
],
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"comment": "If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called \"first name\" since given names do not always come first.",
"first name",
"middle name"
],
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.",
},
],
{
}
],
]
},
{
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "A contact detail for the practitioner, e.g. a telephone number or an email address.",
"comment": "While IPS-UV considers Practitioner.telecom a Must Support element, a number of jurisdictional systems may not capture telecom for practitioner today, even in the scope of a practitioner that is the performer of an observation or diagnostic report. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.",
"requirements": "Need to know how to reach a practitioner independent to any roles the practitioner may have.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "Address(es) of the practitioner that are not role specific (typically home address). \nWork addresses are not typically entered in this property as they are usually role dependent.",
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content.",
"requirements": "The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.",
},
],
{
}
],
{
},
{
}
],
},
{
},
{
},
{
}
]
},
{
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"requirements": "Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.",
},
],
{
}
],
{
},
{
}
]
},
{
"definition": "The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"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](extensibility.html#modifierExtension).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
]
},
{
},
],
{
}
],
{
}
],
},
{
},
{
}
]
},
{
},
],
{
}
],
{
},
{
}
]
},
{
},
{
}
],
{
}
],
]
},
{
"comment": "The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.",
"requirements": "Knowing which language a practitioner speaks can help in facilitating communication with patients.",
},
],
{
}
],
{
},
{
},
{
}
],
},
{
},
{
},
{
}
]
}
]
},
{
{
}
],
},
{
},
{
},
{
"comment": "While IPS-UV considers Practitioner.telecom a Must Support element, a number of jurisdictional systems may not capture telecom for practitioner today, even in the scope of a practitioner that is the performer of an observation or diagnostic report. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content."
},
{
"comment": "IPS-UV flags this as a Must Support element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received. Vendors should expect that some jurisdictions may add a Must Support requirement within the context of their own jurisdictional content."
}
]
}
}
Terminology bindings (Differential)
Terminology bindings (Snapshot)
| Path | Conformance | ValueSet |
|---|---|---|
| Practitioner.language | preferred | http://hl7.org/fhir/ValueSet/languages |
| Practitioner.name.use | required | http://hl7.org/fhir/ValueSet/name-use|4.0.1 |
| Practitioner.gender | required | http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 |
| Practitioner.qualification.code | example | http://terminology.hl7.org/ValueSet/v2-2.7-0360 |
| Practitioner.communication | preferred | http://hl7.org/fhir/ValueSet/languages |
Constraints
| Path | Id | Grade | Details | Expression |
|---|---|---|---|---|
| Practitioner.name | psca-pract-1 | error | Practitioner.name.given or Practitioner.name.family or both SHALL be present | family.exists() or given.exists() |
Obligations
Key Differences between the IPS-UV and PS-CA
Must Support Differences:
- PS-CA removed a Must Support flag to
Practitioner.telecom - PS-CA removed a Must Support flag to
Practitioner.address
Note: Systems that do support these elements are encouraged to include it in generated Patient Summary documents, and support it when received
Cardinality Differences:
There are no cardinality differences between this profile and IPS-UV
Vocabulary Differences:
There are no vocabulary differences between this profile and IPS-UV
Other differences between the IPS and PS-CA Include:
There are no additional differences between this profile and IPS-UV
Note: Additionally, the use of CA Baseline Pratitioner, PractitionerRole, Organization profiles will be superseded by the CA Core profiles (or profiles that impose the CA Core) in future releases but the current usage of CA Baseline profiles will be maintained until a further stabilized CA Core profile (or further Patient Summary requirements) exist.