<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="consent-as-contract" />
  <meta>
    <lastUpdated value="2018-04-17T01:03:00.638-04:00" />
  </meta>
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">This FHIR DSTU2 (Release 2) Consent profile describes how to use the Contract resource needs to represent and persist patient consent for treatment, research, or disclosure (e.g. 42 CFR Part 2, Title 38). Prior to FHIR Release 3 (STU3), implementers where required to use the Contract resource to    represent an electronic patient's consent.
   Since a Contract is not sufficient to represent a granular consent, implementers need to use both a List and one or more Basic resources to define granular references to specific protected data types. 
   The contained resources (List and Basic) allow us to enhance the structure of DSTU3 Contract specify protected data sets (e.g. HIV-related, Substance Use Disorder, STI) specified in a granular patient consent.  A simple opt-in consent consistent with previous specifications and policies (e.g. DURSA) do not require any other resources besides the Contract conforming to the Consent-as-Contract). List of consent items (Basic resources).
      Dependencies:
   Consents that conform to this profile will include reference other resources:  Patient (as patient and/or consenting party), RelatedPerson (as consenting party), Practitioner (custodians, information recipients), and Organization (custodian, custodians, information recipients).
   Typically, the resources referring to the patients, related persons, providers, organizations are described as external   references to resources stored on the same server as the Contract (Consent-as-Contract) resource,  Instances of Consent-as-Contract will reference a List resources that must conform to the profile specified in the parent implementation guide    (URL: http://hl7.org/fhir/us/core/StructureDefinition/consent-as-contract-list).
</div>
  </text>
  <url value="http://hl7.org/fhir/us/core/StructureDefinition/consent-as-contract" />
  <version value="1" />
  <name value="Consent using Contract" />
  <status value="draft" />
  <date value="2018-04-13T03:14:08.2197818-04:00" />
  <publisher value="TBD" />
  <contact>
    <name value="Ioana Singureanu" />
  </contact>
  <description value="This FHIR DSTU2 (Release 2) Consent profile describes how to use the Contract resource needs to represent and persist patient consent for treatment, research, or disclosure (e.g. 42 CFR Part 2, Title 38). Prior to FHIR Release 3 (STU3), implementers where required to use the Contract resource to    represent an electronic patient's consent.&#xD;&#xA;   Since a Contract is not sufficient to represent a granular consent, implementers need to use both a List and one or more Basic resources to define granular references to specific protected data types. &#xD;&#xA;   The contained resources (List and Basic) allow us to enhance the structure of DSTU3 Contract specify protected data sets (e.g. HIV-related, Substance Use Disorder, STI) specified in a granular patient consent.  A simple opt-in consent consistent with previous specifications and policies (e.g. DURSA) do not require any other resources besides the Contract conforming to the Consent-as-Contract). List of consent items (Basic resources).&#xD;&#xA;      Dependencies:&#xD;&#xA;   Consents that conform to this profile will include reference other resources:  Patient (as patient and/or consenting party), RelatedPerson (as consenting party), Practitioner (custodians, information recipients), and Organization (custodian, custodians, information recipients).&#xD;&#xA;   Typically, the resources referring to the patients, related persons, providers, organizations are described as external   references to resources stored on the same server as the Contract (Consent-as-Contract) resource,  Instances of Consent-as-Contract will reference a List resources that must conform to the profile specified in the parent implementation guide    (URL: http://hl7.org/fhir/us/core/StructureDefinition/consent-as-contract-list)." />
  <copyright value="TBD" />
  <fhirVersion value="1.0.2" />
  <kind value="resource" />
  <abstract value="false" />
  <snapshot>
    <element id="Contract">
      <path value="Contract" />
    </element>
    <element id="Contract.identifier">
      <path value="Contract.identifier" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Contract.issued">
      <path value="Contract.issued" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Contract.applies">
      <path value="Contract.applies" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Contract.subject">
      <path value="Contract.subject" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Contract.authority">
      <path value="Contract.authority" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
      <comments value="This data element references the organiation that holds the information covered by consent." />
    </element>
    <element id="Contract.type">
      <path value="Contract.type" />
      <max value="0" />
    </element>
    <element id="Contract.subType">
      <path value="Contract.subType" />
      <max value="0" />
    </element>
    <element id="Contract.action">
      <path value="Contract.action" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Contract.actionReason">
      <path value="Contract.actionReason" />
      <definition value="Reason for action stipulated by this Contract. In the case of consent, this data element specifies the &quot;Purpose of use&quot; (e.g. TREAT for treatment, HRESCH for research)" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Contract.actor">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Actor" />
      </extension>
      <path value="Contract.actor" />
      <min value="1" />
      <mustSupport value="true" />
      <comments value="Intended recipients of the data referenced in the consent. Typically the references may include Practioner or Organization resources but a RelatedPerson (e.g. next-of-kin) may also be applicable." />
    </element>
    <element id="Contract.valuedItem">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="ValuedItem" />
      </extension>
      <path value="Contract.valuedItem" />
      <max value="0" />
    </element>
    <element id="Contract.signer">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Signatory" />
      </extension>
      <path value="Contract.signer" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Contract.term">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Term" />
      </extension>
      <path value="Contract.term" />
      <requirements value="The Contract.terms are for granular consent, to specify the protected information addressed by the patient's consent." />
      <max value="1" />
      <mustSupport value="true" />
      <name value="term" />
    </element>
    <element id="Contract.binding[x]">
      <path value="Contract.binding[x]" />
      <max value="0" />
    </element>
    <element id="Contract.friendly">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="FriendlyLanguage" />
      </extension>
      <path value="Contract.friendly" />
      <max value="0" />
    </element>
    <element id="Contract.legal">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="LegalLanguage" />
      </extension>
      <path value="Contract.legal" />
      <max value="0" />
    </element>
    <element id="Contract.rule">
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="ComputableLanguage" />
      </extension>
      <path value="Contract.rule" />
      <comments value="This data element may be used to specify a computable representation of a consent (e.g. XACML, OAUth2). The policies or scopes are computed based on the Constract.term information ." />
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="Contract" />
    </element>
    <element>
      <path value="Contract.identifier" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.identifier.use" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.identifier.type" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.identifier.system" />
      <meaningWhenMissing value="The identifier is GUID" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.identifier.value" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.identifier.period" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.identifier.assigner" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.issued" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.applies" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.applies.start" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.applies.end" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.subject" />
      <min value="1" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient" />
      </type>
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.authority" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
      <comments value="This data element references the organiation that holds the information covered by consent." />
    </element>
    <element>
      <path value="Contract.type" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.subType" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.action" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.action.coding" />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <valueSetUri value="http://hl7.org/fhir/ValueSet/consent-action" />
      </binding>
      <exampleCoding>
        <system value="http://hl7.org/fhir/consentaction" />
        <code value="disclose" />
      </exampleCoding>
    </element>
    <element>
      <path value="Contract.action.coding.system" />
      <fixedUri value="http://hl7.org/fhir/consentaction" />
    </element>
    <element>
      <path value="Contract.action.coding.code" />
      <defaultValueCode value="disclose" />
      <fixedCode value="disclose" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.actionReason" />
      <definition value="Reason for action stipulated by this Contract. In the case of consent, this data element specifies the &quot;Purpose of use&quot; (e.g. TREAT for treatment, HRESCH for research)" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.actionReason.coding" />
      <mustSupport value="true" />
      <binding>
        <strength value="extensible" />
        <valueSetUri value="http://hl7.org/fhir/ValueSet/v3-PurposeOfUs" />
      </binding>
      <exampleCoding>
        <system value="http://hl7.org/fhir/v3/ActReason" />
        <code value="TREAT" />
        <display value="treatment" />
      </exampleCoding>
    </element>
    <element>
      <path value="Contract.actionReason.coding.system" />
      <meaningWhenMissing value="http://hl7.org/fhir/v3/ActReason" />
      <mustSupport value="true" />
      <exampleUri value="http://hl7.org/fhir/v3/ActReason" />
    </element>
    <element>
      <path value="Contract.actionReason.coding.version" />
      <max value="0" />
      <mustSupport value="false" />
    </element>
    <element>
      <path value="Contract.actionReason.coding.code" />
      <min value="1" />
      <mustSupport value="true" />
      <exampleCode value="TREAT" />
    </element>
    <element>
      <path value="Contract.actionReason.coding.display" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.actionReason.coding.userSelected" />
      <max value="0" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Actor" />
      </extension>
      <path value="Contract.actor" />
      <min value="1" />
      <mustSupport value="true" />
      <comments value="Intended recipients of the data referenced in the consent. Typically the references may include Practioner or Organization resources but a RelatedPerson (e.g. next-of-kin) may also be applicable." />
    </element>
    <element>
      <path value="Contract.actor.entity" />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Organization" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
      </type>
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson" />
      </type>
    </element>
    <element>
      <path value="Contract.actor.role" />
      <max value="1" />
    </element>
    <element>
      <path value="Contract.actor.role.coding.system" />
      <fixedUri value="http://hl7.org/fhir/v3/ParticipationType" />
    </element>
    <element>
      <path value="Contract.actor.role.coding.code" />
      <fixedCode value="IRCP" />
    </element>
    <element>
      <path value="Contract.actor.role.text" />
      <fixedString value="Information Recipient" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="ValuedItem" />
      </extension>
      <path value="Contract.valuedItem" />
      <max value="0" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Signatory" />
      </extension>
      <path value="Contract.signer" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Term" />
      </extension>
      <path value="Contract.term" />
      <requirements value="The Contract.terms are for granular consent, to specify the protected information addressed by the patient's consent." />
      <max value="1" />
      <mustSupport value="true" />
      <name value="term" />
    </element>
    <element>
      <path value="Contract.term.identifier" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.term.issued" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.term.applies" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.term.type" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.term.subType" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.term.subject" />
      <requirements value="It specifies the list of data types referenced by the consent." />
      <type>
        <code value="Reference" />
        <profile value="http://hl7.org/fhir/us/core/StructureDefinition/consent-as-contract-list" />
        <aggregation value="contained" />
      </type>
      <meaningWhenMissing value="If the Contract.erm.subject is missing, this consent is intended to cover all the protected data for the patient referenced in the Contract.subject." />
      <mustSupport value="true" />
      <comments value="This data element contains a reference to the List that specifies the categories of information covered by the patient&#xD;&#xA;s consent." />
    </element>
    <element>
      <path value="Contract.term.subject.reference" />
      <mustSupport value="true" />
    </element>
    <element>
      <path value="Contract.term.action" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.term.actionReason" />
      <max value="0" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="TermActor" />
      </extension>
      <path value="Contract.term.actor" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.term.text" />
      <max value="0" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="TermValuedItem" />
      </extension>
      <path value="Contract.term.valuedItem" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.term.group" />
      <max value="0" />
    </element>
    <element>
      <path value="Contract.binding[x]" />
      <max value="0" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="FriendlyLanguage" />
      </extension>
      <path value="Contract.friendly" />
      <max value="0" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="LegalLanguage" />
      </extension>
      <path value="Contract.legal" />
      <max value="0" />
    </element>
    <element>
      <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="ComputableLanguage" />
      </extension>
      <path value="Contract.rule" />
      <comments value="This data element may be used to specify a computable representation of a consent (e.g. XACML, OAUth2). The policies or scopes are computed based on the Constract.term information ." />
    </element>
  </differential>
  <constrainedType value="Contract" />
  <base value="http://hl7.org/fhir/StructureDefinition/Contract" />
</StructureDefinition>