Nexus EMR Item Consent Profile Core Profile

Canonical	../StructureDefinition/nexus-emr-core-item-consent
Status	draft · 1.26.0
Base	Consent (constraint)
Source	FSH · JSON

Patient-level consent for one catalogue item — whether the clinic may email the patient, text the patient, or use an AI scribe during their visit. Recorded manually by clinic staff from what the patient tells them, not captured through a patient-facing flow.

Examples

AI Scribe DECLINED With Evidence · Email PROVIDED · SMS DECLINED

SMS DECLINED

Item consent with status rejected (Declined) for the SMS item, demonstrating the free-text status reason extension

Consent/nexus-emr-item-consent-sms-declined — claims conformance to Nexus EMR Item Consent Profile Core

{
  "resourceType": "Consent",
  "id": "nexus-emr-item-consent-sms-declined",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-item-consent"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Item Consent - SMS - DECLINED</b></p><p>Patient: <strong>Avery Linwood</strong> has <strong>DECLINED</strong> the <strong>SMS</strong> item — the clinic may not text her, for clinical or routine purposes.</p><p>Reason given: <em>Patient prefers phone calls only</em></p><p>Recorded by: <strong>Dr. Emil Navarro</strong> on April 8, 2025 at 10:36 AM</p><p>Status: rejected (Declined). The same code is used for an initial decline and for a later withdrawal, so consumers check one code.</p><p><strong>The decision is <code>provision.type = deny</code>, not <code>status</code>.</strong> Status is <code>active</code> because the record is operative; it says nothing about the answer. Earlier releases carried a declined item as <code>status = rejected</code>, which made one element mean opposite things across the Consent families sharing this store.</p></div>"
  },
  "extension": [
    {
      "url": "../StructureDefinition/nexus-consent-status-reason",
      "valueString": "Patient prefers phone calls only"
    }
  ],
  "status": "active",
  "scope": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/consentscope",
        "code": "patient-privacy",
        "display": "Privacy Consent"
      }
    ]
  },
  "category": [
    {
      "coding": [
        {
          "system": "../CodeSystem/nexus-consent-item",
          "code": "sms",
          "display": "SMS"
        }
      ]
    },
    {
      "coding": [
        {
          "system": "../CodeSystem/nexus-consent-family",
          "code": "item",
          "display": "Item consent"
        }
      ]
    }
  ],
  "patient": {
    "reference": "Patient/avery-linwood",
    "display": "Avery Linwood"
  },
  "dateTime": "2025-04-08T10:36:00-06:00",
  "performer": [
    {
      "reference": "Practitioner/dr-emil-navarro",
      "display": "Dr. Emil Navarro"
    }
  ],
  "policy": [
    {
      "uri": "../policy/nexus-privacy-policy"
    }
  ],
  "provision": {
    "type": "deny"
  }
}