Privacy Directive Profile

Canonical	../StructureDefinition/nexus-privacy-directive
Status	draft (experimental) · 1.26.0
Base	Consent (constraint)
Source	FSH · JSON

A patient's standing restriction on the collection, use or disclosure of their own personal health information -- the instruction PHIPA calls a lockbox.

Examples

Nexus privacy directive lockbox named record · Nexus privacy directive lockbox whole record

Nexus privacy directive lockbox whole record

Consent/nexus-privacy-directive-lockbox-whole-record — claims conformance to Privacy Directive Profile

{
  "resourceType": "Consent",
  "id": "nexus-privacy-directive-lockbox-whole-record",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-privacy-directive"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Privacy directive - whole record - DISCLOSURE RESTRICTED, with a standing break-glass exception</b></p><p><strong>Avery Linwood</strong> has instructed Cedarbrook Clinic not to disclose any of her record outside the clinic. Given in person on 12 June 2026, effective from that date, with no end.</p><p><strong>The decision is <code>provision.type = deny</code> on the ROOT provision</strong>, following IHE PCF and Ontario's PCOI. R4's own element text says type is not permitted on the root; both prior arts require it anyway, and this guide follows them so that the decision sits where a PCF reader looks first.</p><p><strong>Break-glass is the nested permit, not a second resource.</strong> The exception names the custodian and carries <code>purpose = BTG</code>. A Group standing for a narrower set of privileged users would be better and the profile permits one; this guide does not yet profile Group, which is a stated first-pass limit rather than a modelling opinion. It says who MAY break the glass. It does not say anybody did - that record is an AuditEvent, and there is one in this example set.</p><p>Status is <code>active</code>, and on this profile that means the RESTRICTION is in force. An active item consent means the opposite. Select on <code>category</code> before reading <code>status</code>.</p><p>No <code>provision.data</code> is named, so the restriction covers the whole record including information recorded after this date.</p></div>"
  },
  "identifier": [
    {
      "system": "../NamingSystem/nexus-privacy-directive-identifier",
      "value": "avery-linwood-2026-06-12-01"
    }
  ],
  "status": "active",
  "scope": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/consentscope",
        "code": "patient-privacy",
        "display": "Privacy Consent"
      }
    ]
  },
  "category": [
    {
      "coding": [
        {
          "system": "../CodeSystem/nexus-consent-family",
          "code": "privacy-directive",
          "display": "Privacy directive"
        }
      ]
    }
  ],
  "patient": {
    "reference": "Patient/avery-linwood",
    "display": "Avery Linwood"
  },
  "dateTime": "2026-06-12T14:20:00-04:00",
  "performer": [
    {
      "reference": "Patient/avery-linwood",
      "display": "Avery Linwood"
    }
  ],
  "organization": [
    {
      "reference": "Organization/cedarbrook-clinic",
      "display": "Cedarbrook Clinic"
    }
  ],
  "policy": [
    {
      "uri": "https://www.ontario.ca/laws/statute/04p03#BK37"
    }
  ],
  "provision": {
    "type": "deny",
    "period": {
      "start": "2026-06-12"
    },
    "action": [
      {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/consentaction",
            "code": "disclose",
            "display": "Disclose"
          }
        ]
      }
    ],
    "provision": [
      {
        "type": "permit",
        "actor": [
          {
            "role": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                  "code": "IRCP",
                  "display": "information recipient"
                }
              ]
            },
            "reference": {
              "reference": "Organization/cedarbrook-clinic",
              "display": "Cedarbrook Clinic (clinicians authorized to break the glass)"
            }
          }
        ],
        "purpose": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
            "code": "BTG",
            "display": "break the glass"
          }
        ]
      }
    ]
  }
}

Referenced by: audit-avery-break-glass-20260903