UK Core Implementation Guide STU3 Sequence

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This version of the UK Core is for C&TA Sprint 7 Review.
This version is not suitable for implementation. Other versions are available on the UK Core Version History Guide
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Canonical_URL	Current_Version	Last_Updated	Description
https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent	2.3.0	2023-04-28	This profile defines the UK constraints and extensions on the International FHIR resource Consent.

Profile_Purpose
The purpose of this profile is to be used to express a Consent regarding Healthcare. There are four anticipated uses for the Consent Resource, all of which are written or verbal agreements by a healthcare consumer [grantor] or a personal representative, made to an authorised entity [grantee] concerning authorised or restricted actions with any limitations on purpose of use, and handling instructions to which the authorised entity SHALL comply: Privacy Consent Directive: Agreement to collect, access, use or disclose (share) information. Medical Treatment Consent Directive: Consent to undergo a specific treatment (or record of refusal to consent). Research Consent Directive: Consent to participate in research protocol and information sharing required. Advance Care Directives: Consent to instructions for potentially needed medical treatment (e.g. DNR).

Profile_Purpose

The purpose of this profile is to be used to express a Consent regarding Healthcare. There are four anticipated uses for the Consent Resource, all of which are written or verbal agreements by a healthcare consumer [grantor] or a personal representative, made to an authorised entity [grantee] concerning authorised or restricted actions with any limitations on purpose of use, and handling instructions to which the authorised entity SHALL comply:

Privacy Consent Directive: Agreement to collect, access, use or disclose (share) information.
Medical Treatment Consent Directive: Consent to undergo a specific treatment (or record of refusal to consent).
Research Consent Directive: Consent to participate in research protocol and information sharing required.
Advance Care Directives: Consent to instructions for potentially needed medical treatment (e.g. DNR).

Consent	I		Consent	There are no (further) constraints on this element Element Id Consent Short description A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Definition A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time. Comments Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives. Data Type Consent Constraints dom-2:If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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 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-6:A resource should have narrative for robust management text.`div`.exists() dom-5:If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` ppc-4:IF Scope=adr, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()` ppc-5:IF Scope=treatment, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()` ppc-2:IF Scope=privacy, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()` ppc-3:IF Scope=research, there must be a patient `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()` ppc-1:Either a Policy or PolicyRule `policy.exists() or policyRule.exists()` Mappings rim:Entity. Role, or Act workflow:Event v2:CON rim:FinancialConsent
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element Id Consent.identifier Short description Identifier for this record (external references) Definition Unique identifier for this copy of the Consent Statement. Comments This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same. Data Type Identifier Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Examples General { "system": "urn:ietf:rfc:3986", "value": "Local eCMS identifier" } Mappings rim:n/a v2:CX / EI (occasionally, more often EI maps to a resource id or a URL) rim:II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd:Identifier workflow:Event.identifier w5:FiveWs.identifier rim:.id
use	Σ ?!	0..1	codeBinding	There are no (further) constraints on this element Element Id Consent.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 rim:n/a 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 Consent.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 rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD v2:CX.5 rim:Role.code or implied by context
system	Σ	0..1	uri	There are no (further) constraints on this element Element Id Consent.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 rim:n/a v2:CX.4 / EI-2-4 rim:II.root or Role.id.root servd:./IdentifierType
value	Σ	0..1	string	There are no (further) constraints on this element Element Id Consent.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 rim:n/a 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 I	0..1	Period	There are no (further) constraints on this element Element Id Consent.identifier.period Short description Time period when id is/was valid for use Definition Time period during which identifier is/was valid for use. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] v2:CX.7 + CX.8 rim:Role.effectiveTime or implied by context servd:./StartDate and ./EndDate
assigner	Σ I	0..1	Reference(UK Core Organization)	Element Id Consent.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(UK Core Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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
status	Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element Id Consent.status Short description draft \| proposed \| active \| rejected \| inactive \| entered-in-error Definition Indicates the current state of this consent. Requirements The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. Comments This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid. Data Type code Binding Indicates the state of the consent. ConsentState (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.status w5:FiveWs.status v2:HL7 Table 0498 - Consent Status rim:.statusCode
scope	Σ ?!	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.scope Short description Which of the four areas this resource covers (extensible) Definition A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding The four anticipated uses for the Consent Resource. ConsentScopeCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
category	Σ	1..*	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.category Short description Classification of the consent statement - for indexing/retrieval Definition A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding A classification of the type of consents found in a consent statement. ConsentCategoryCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD workflow:Event.code w5:FiveWs.class v2:HL7 Table 0497 - Consent Type rim:CNTRCT
patient	Σ I	0..1	Reference(UK Core Patient)	Element Id Consent.patient Short description Who the consent applies to Definition The patient/healthcare consumer to whom this consent applies. Comments Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person. Data Type Reference(UK Core Patient) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.subject w5:FiveWs.subject[x] rim:Role w5:FiveWs.subject
dateTime	Σ	0..1	dateTime	There are no (further) constraints on this element Element Id Consent.dateTime Short description When this Consent was created or indexed Definition When this Consent was issued / created / indexed. Comments This is not the time of the original consent, but the time that this statement was made or derived. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a workflow:Event.occurrence[x] w5:FiveWs.recorded v2:Field 13/ Consent Decision Date rim:FinancialConsent effectiveTime
performer	Σ I	0..*	Reference(UK Core Organization \| UK Core Patient \| UK Core Practitioner \| UK Core PractitionerRole \| UK Core RelatedPerson)	Element Id Consent.performer Short description Who is agreeing to the policy and rules Alternate names consentor Definition Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions. Comments Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian. Data Type Reference(UK Core Organization \| UK Core Patient \| UK Core Practitioner \| UK Core PractitionerRole \| UK Core RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.actor v2:Field 24/ ConsenterID
organization	Σ I	0..*	Reference(UK Core Organization)	Element Id Consent.organization Short description Custodian of the consent Alternate names custodian Definition The organization that manages the consent, and the framework within which it is executed. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(UK Core Organization) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow:Event.performer w5:FiveWs.witness
source[x]	Σ	0..1		There are no (further) constraints on this element Element Id Consent.source[x] Short description Source from which this consent is taken Definition The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document. Comments The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id. Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:Field 19 Informational Material Supplied Indicator
sourceAttachment			Attachment	Data Type Attachment
sourceReference			Reference(UK Core DocumentReference \| Contract \| UK Core QuestionnaireResponse \| UK Core Consent)	Data Type Reference(UK Core DocumentReference \| Contract \| UK Core QuestionnaireResponse \| UK Core Consent)
policy		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.policy Short description Policies covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
authority	I	0..1	uri	There are no (further) constraints on this element Element Id Consent.policy.authority Short description Enforcement source for policy Definition Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives. Comments see http://en.wikipedia.org/wiki/Uniform_resource_identifier Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
uri	I	0..1	uri	There are no (further) constraints on this element Element Id Consent.policy.uri Short description Specific policy covered by this consent Definition The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law. Comments This element is for discoverability / documentation and does not modify or qualify the policy rules. Data Type uri Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
policyRule	Σ I	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.policyRule Short description Regulation that this consents to Definition A reference to the specific base computable regulation or policy. Requirements Might be a unique identifier of a policy set in XACML, or other rules engine. Comments If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource. Data Type CodeableConcept Binding Regulatory policy examples. ConsentPolicyRuleCodes (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
verification	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.verification Short description Consent Verified by patient or family Definition Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person. Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verified	Σ	1..1	boolean	There are no (further) constraints on this element Element Id Consent.verification.verified Short description Has been verified Definition Has the instruction been verified. Data Type boolean Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
verifiedWith	I	0..1	Reference(UK Core Patient \| UK Core RelatedPerson)	Element Id Consent.verification.verifiedWith Short description Person who verified Definition Who verified the instruction (Patient, Relative or other Authorized Person). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(UK Core Patient \| UK Core RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
verificationDate		0..1	dateTime	There are no (further) constraints on this element Element Id Consent.verification.verificationDate Short description When consent verified Definition Date verification was collected. Data Type dateTime Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
provision	Σ	0..1	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision Short description Constraints to the base Consent.policyRule Definition An exception to the base policy of this consent. An exception can be an addition or removal of access permissions. Data Type BackboneElement 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	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.type Short description deny \| permit Definition Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a rule statement is applied, such as adding additional consent or removing consent. ConsentProvisionType (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
period	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.period Short description Timeframe for this rule Definition The timeframe in this rule is valid. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
actor		0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.actor Short description Who\|what controlled by this rule (or group, by role) Definition Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Meaning When Missing There is no specific actor associated with the exception Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
role		1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Consent.provision.actor.role Short description How the actor is involved Definition How the individual is involved in the resources content that is described in the exception. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data Type CodeableConcept Binding How an actor is involved in the consent considerations. SecurityRoleType (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
reference	I	1..1	Reference(UK Core Device \| Group \| UK Core CareTeam \| UK Core Organization \| UK Core Patient \| UK Core Practitioner \| UK Core PractitionerRole \| UK Core RelatedPerson)	Element Id Consent.provision.actor.reference Short description Resource for the actor (or group, by role) Definition The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers'). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(UK Core Device \| Group \| UK Core CareTeam \| UK Core Organization \| UK Core Patient \| UK Core Practitioner \| UK Core PractitionerRole \| UK Core RelatedPerson) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
action	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id Consent.provision.action Short description Actions controlled by this rule Definition Actions controlled by this Rule. Comments Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'. Meaning When Missing all actions Data Type CodeableConcept Binding Detailed codes for the consent action. ConsentActionCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
securityLabel	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.securityLabel Short description Security Labels that define affected resources Definition A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception. Comments If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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
purpose	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.purpose Short description Context of activities covered by this rule Definition The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule. Comments When the purpose of use tag is on the data, access request purpose of use shall not conflict. Data Type Coding Binding What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. v3.PurposeOfUse (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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
class	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element Id Consent.provision.class Short description e.g. Resource Type, Profile, CDA, etc. Definition The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to. Comments Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere. Data Type Coding Binding The class (type) of information a consent rule covers. ConsentContentClass (extensible) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (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
code	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element Id Consent.provision.code Short description e.g. LOINC or SNOMED CT code, etc. in the content Definition If this code is found in an instance, then the rule applies. Comments Typical use of this is a Document code with class = CDA. Data Type CodeableConcept Binding If this code is found in an instance, then the exception applies. ConsentContentCodes (example) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a v2:CE/CNE/CWE rim:CD orim:fhir:CodeableConcept rdfs:subClassOf dt:CD
dataPeriod	Σ I	0..1	Period	There are no (further) constraints on this element Element Id Consent.provision.dataPeriod Short description Timeframe for data controlled by this rule Definition Clinical or Operational Relevant period of time that bounds the data controlled by this rule. Comments This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement. Data Type Period Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1:If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim:n/a v2:DR rim:IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
data	Σ	0..*	BackboneElement	There are no (further) constraints on this element Element Id Consent.provision.data Short description Data controlled by this rule Definition The resources controlled by this rule if specific resources are referenced. Meaning When Missing all data Data Type BackboneElement Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a rim:Role
meaning	Σ	1..1	codeBinding	There are no (further) constraints on this element Element Id Consent.provision.data.meaning Short description instance \| related \| dependents \| authoredby Definition How the resource reference is interpreted when testing consent restrictions. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data Type code Binding How a resource reference is interpreted when testing consent restrictions. ConsentDataMeaning (required) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim:n/a
reference	Σ I	1..1	Reference(Resource)	There are no (further) constraints on this element Element Id Consent.provision.data.reference Short description The actual data reference Definition A reference to a specific resource that defines which resources are covered by this consent. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data Type Reference(Resource) Constraints ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1:SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim:n/a rim:The target of a resource reference is a RIM entry point (Act, Role, or Entity)
provision		0..*	see (provision)	There are no (further) constraints on this element Element Id Consent.provision.provision Short description Nested Exception Rules Definition Rules which provide exceptions to the base rule or subrules.

Table View

Consent		..
Consent.identifier		..
Consent.identifier.assigner	Reference(UK Core Organization)	..
Consent.patient	Reference(UK Core Patient)	..
Consent.performer	Reference(UK Core Organization \| UK Core Patient \| UK Core Practitioner \| UK Core PractitionerRole \| UK Core RelatedPerson)	..
Consent.organization	Reference(UK Core Organization)	..
Consent.source[x]	Attachment, Reference(UK Core DocumentReference \| Contract \| UK Core QuestionnaireResponse \| UK Core Consent)	..
Consent.verification		..
Consent.verification.verifiedWith	Reference(UK Core Patient \| UK Core RelatedPerson)	..
Consent.provision		..
Consent.provision.actor		..
Consent.provision.actor.reference	Reference(UK Core Device \| Group \| UK Core CareTeam \| UK Core Organization \| UK Core Patient \| UK Core Practitioner \| UK Core PractitionerRole \| UK Core RelatedPerson)	..

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="UKCore-Consent" />
    <url value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent" />
    <version value="2.3.0" />
    <name value="UKCoreConsent" />
    <title value="UK Core Consent" />
    <status value="active" />
    <date value="2023-04-28" />
    <publisher value="HL7 UK" />
    <contact>
        <name value="HL7 UK" />
        <telecom>
            <system value="email" />
            <value value="ukcore@hl7.org.uk" />
            <use value="work" />
            <rank value="1" />
        </telecom>
    </contact>
    <description value="This profile defines the UK constraints and extensions on the International FHIR resource [Consent](https://hl7.org/fhir/R4/Consent.html)." />
    <purpose value="The purpose of this profile is to be used to express a Consent regarding Healthcare. There are four anticipated uses for the Consent Resource, all of which are written or verbal agreements by a healthcare consumer [grantor] or a personal representative, made to an authorised entity [grantee] concerning authorised or restricted actions with any limitations on purpose of use, and handling instructions to which the authorised entity SHALL comply: \n- **Privacy Consent Directive**: Agreement to collect, access, use or disclose (share) information. \n- **Medical Treatment Consent Directive**: Consent to undergo a specific treatment (or record of refusal to consent). \n- **Research Consent Directive**: Consent to participate in research protocol and information sharing required. \n- **Advance Care Directives**: Consent to instructions for potentially needed medical treatment (e.g. DNR)." />
    <copyright value="Copyright &#169; 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the &quot;License&quot;); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an &quot;AS IS&quot; BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7&#174; FHIR&#174; standard Copyright &#169; 2011+ HL7 The HL7&#174; FHIR&#174; standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html." />
    <fhirVersion value="4.0.1" />
    <mapping>
        <identity value="workflow" />
        <uri value="http://hl7.org/fhir/workflow" />
        <name value="Workflow Pattern" />
    </mapping>
    <mapping>
        <identity value="v2" />
        <uri value="http://hl7.org/v2" />
        <name value="HL7 v2 Mapping" />
    </mapping>
    <mapping>
        <identity value="rim" />
        <uri value="http://hl7.org/v3" />
        <name value="RIM Mapping" />
    </mapping>
    <mapping>
        <identity value="w5" />
        <uri value="http://hl7.org/fhir/fivews" />
        <name value="FiveWs Pattern Mapping" />
    </mapping>
    <kind value="resource" />
    <abstract value="false" />
    <type value="Consent" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Consent" />
    <derivation value="constraint" />
    <differential>
        <element id="Consent.identifier.assigner">
            <path value="Consent.identifier.assigner" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Consent.patient">
            <path value="Consent.patient" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
            </type>
        </element>
        <element id="Consent.performer">
            <path value="Consent.performer" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
            </type>
        </element>
        <element id="Consent.organization">
            <path value="Consent.organization" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
            </type>
        </element>
        <element id="Consent.source[x]">
            <path value="Consent.source[x]" />
            <type>
                <code value="Attachment" />
            </type>
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-DocumentReference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Contract" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-QuestionnaireResponse" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent" />
            </type>
        </element>
        <element id="Consent.verification.verifiedWith">
            <path value="Consent.verification.verifiedWith" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
            </type>
        </element>
        <element id="Consent.provision.actor.reference">
            <path value="Consent.provision.actor.reference" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole" />
                <targetProfile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson" />
            </type>
        </element>
    </differential>
</StructureDefinition>

JSON View

{
    "resourceType": "StructureDefinition",
    "id": "UKCore-Consent",
    "url": "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent",
    "version": "2.3.0",
    "name": "UKCoreConsent",
    "title": "UK Core Consent",
    "status": "active",
    "date": "2023-04-28",
    "publisher": "HL7 UK",
    "contact":  [
        {
            "name": "HL7 UK",
            "telecom":  [
                {
                    "system": "email",
                    "value": "ukcore@hl7.org.uk",
                    "use": "work",
                    "rank": 1
                }
            ]
        }
    ],
    "description": "This profile defines the UK constraints and extensions on the International FHIR resource [Consent](https://hl7.org/fhir/R4/Consent.html).",
    "purpose": "The purpose of this profile is to be used to express a Consent regarding Healthcare. There are four anticipated uses for the Consent Resource, all of which are written or verbal agreements by a healthcare consumer [grantor] or a personal representative, made to an authorised entity [grantee] concerning authorised or restricted actions with any limitations on purpose of use, and handling instructions to which the authorised entity SHALL comply: \n- **Privacy Consent Directive**: Agreement to collect, access, use or disclose (share) information. \n- **Medical Treatment Consent Directive**: Consent to undergo a specific treatment (or record of refusal to consent). \n- **Research Consent Directive**: Consent to participate in research protocol and information sharing required. \n- **Advance Care Directives**: Consent to instructions for potentially needed medical treatment (e.g. DNR).",
    "copyright": "Copyright © 2021+ HL7 UK Licensed under the Apache License, Version 2.0 (the \"License\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \"AS IS\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
    "fhirVersion": "4.0.1",
    "mapping":  [
        {
            "identity": "workflow",
            "uri": "http://hl7.org/fhir/workflow",
            "name": "Workflow Pattern"
        },
        {
            "identity": "v2",
            "uri": "http://hl7.org/v2",
            "name": "HL7 v2 Mapping"
        },
        {
            "identity": "rim",
            "uri": "http://hl7.org/v3",
            "name": "RIM Mapping"
        },
        {
            "identity": "w5",
            "uri": "http://hl7.org/fhir/fivews",
            "name": "FiveWs Pattern Mapping"
        }
    ],
    "kind": "resource",
    "abstract": false,
    "type": "Consent",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Consent",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Consent.identifier.assigner",
                "path": "Consent.identifier.assigner",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Consent.patient",
                "path": "Consent.patient",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient"
                        ]
                    }
                ]
            },
            {
                "id": "Consent.performer",
                "path": "Consent.performer",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson"
                        ]
                    }
                ]
            },
            {
                "id": "Consent.organization",
                "path": "Consent.organization",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization"
                        ]
                    }
                ]
            },
            {
                "id": "Consent.source[x]",
                "path": "Consent.source[x]",
                "type":  [
                    {
                        "code": "Attachment"
                    },
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-DocumentReference",
                            "http://hl7.org/fhir/StructureDefinition/Contract",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-QuestionnaireResponse",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent"
                        ]
                    }
                ]
            },
            {
                "id": "Consent.verification.verifiedWith",
                "path": "Consent.verification.verifiedWith",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson"
                        ]
                    }
                ]
            },
            {
                "id": "Consent.provision.actor.reference",
                "path": "Consent.provision.actor.reference",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device",
                            "http://hl7.org/fhir/StructureDefinition/Group",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole",
                            "https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson"
                        ]
                    }
                ]
            }
        ]
    }
}

Examples

For Information Access - An example to illustrate a patient giving consent for information access.
Example UKCore-Consent-ForInformationAccess

Usage

This Profile has the following derived profiles:

This Profile is referenced in the following Extensions:

This Profile is referenced in the following Profiles:

id	targetProfile
UKCore-Consent	https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-DocumentReference; http://hl7.org/fhir/StructureDefinition/Contract; https://fhir.hl7.org.uk/StructureDefinition/UKCore-QuestionnaireResponse; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Consent; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Device; http://hl7.org/fhir/StructureDefinition/Group; https://fhir.hl7.org.uk/StructureDefinition/UKCore-CareTeam; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Organization; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Patient; https://fhir.hl7.org.uk/StructureDefinition/UKCore-Practitioner; https://fhir.hl7.org.uk/StructureDefinition/UKCore-PractitionerRole; https://fhir.hl7.org.uk/StructureDefinition/UKCore-RelatedPerson

targetProfile

UKCore-Consent

Example Usage Scenarios

The following are example usage scenarios for the UK Core Consent profile:

Privacy Consent Directive: Agreement to collect, access, use or disclose (share) information.
Medical Treatment Consent Directive: Consent to undergo a specific treatment (or record of refusal to consent).
Research Consent Directive: Consent to participate in research protocol and information sharing required.
Advance Care Directives: Consent to instructions for potentially needed medical treatment (e.g. DNR).

Profile Specific Implementation Guidance:

Minimum Viable Content

A minimum viable content that all provider and consumer systems SHALL support are the following elements.

Element	Reason
`Consent.status`	Indicates the current state of this consent.
`Consent.scope`	A selector of the type of consent being presented: ADR, Privacy, Treatment, Research.
`Consent.category`	The classification of the consent statement - for indexing/retrieval
`Consent.patient`	The patient/healthcare consumer to whom this consent applies.
`Consent.dateTime`	When this consent was issued / created / indexed.
`Consent.performer`	Who is agreeing to the policy and rules
`Consent.organization`	The custodian of the consent
`Consent.source[x]`	The source from which this consent is taken

`patient`

The resource being referenced SHALL conform to the following Profile UKCore-Patient.

`performer`

The resource being referenced SHALL conform to one of the following:

`organization`

The resource being referenced SHALL conform to the following Profile UKCore-Organization.

`source[x]`

The source on which this consent statement is based, either as an inline Attachment, or as a reference. The resource being referenced SHALL conform to one of the following:

`verification`

verification.verifiedWith

The resource being referenced SHALL conform to one of the following:

`provision`

provision.actor.reference

The resource being referenced SHALL conform to one of the following:

provision.data.reference

Where a UK Core profile exists the resource being referenced SHALL conform to the profile.

StructureDefinition-UKCore-Consent

Table View

XML View

JSON View

Examples

Usage

Example Usage Scenarios

Profile Specific Implementation Guidance:

Minimum Viable Content

patient

performer

organization

source[x]

verification

provision

`patient`

`performer`

`organization`

`source[x]`

`verification`

`provision`