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Requisition Signature Extension

Canonical../StructureDefinition/nexus-requisition-signature
Statusdraft · 1.26.0
BaseExtension (constraint)
ContextServiceRequest (element)
SourceFSH · JSON

The clinician's electronic signature on a laboratory requisition: who signed it, and when.

Elements / Details

Every element this profile touches, with its full definition. Element names in the tables link here.

Extension

Short The clinician's electronic signature on the requisition -- who, and when
Definition The clinician's electronic signature on a laboratory requisition: who signed it, and when. An attestation, not a cryptographic signature -- and R4's Signature datatype is built for exactly that. Its type binds ISO/ASTM E1762 attestation kinds (Author's Signature among them) rather than algorithms, and data is optional, so a signature with no digest and no key is valid. A future revision of this extension carries a Signature as its value for that reason; what follows describes the shape written today. This is not the R4 Signature datatype and carries no digest, no signed blob and no key. It records that the authenticated user asserted the requisition at a moment in time. A consumer must not present it as a verifiable cryptographic signature. Presence is the flag. There is no separate stored boolean. A requisition carrying this extension is signed; one without it is not. At most one, and a re-sign replaces it. The form prints one signature line. The sequence of signings is read from the resource's version history, where each stored version carries the signature it was written with and, separately, the reason that version was written. The signer's name is stored on the reference, deliberately. signer.display is the name as it printed on the sheet when it was signed. A reprint must reproduce the issued document from the resource alone, so a later change to the practitioner's recorded name does not change what an already-issued requisition says. No stamp image is referenced. A signature prints as the typed name. The stamp child below is read-only legacy and must never be produced; its absence carries no meaning about validity.
Cardinality 0..*
Invariants ele-1, ext-1

Extension.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension

Short Additional content defined by implementations
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.
Comments 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.
Cardinality 2..*
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:signer

Short Who signed -- the ordering clinician, as a PractitionerRole where one resolved
Definition The clinician who signed the requisition. A PractitionerRole where the signing context resolved one, otherwise the Practitioner. display carries the name exactly as it printed on the signed sheet and is stored so a reprint does not change when the practitioner record does.
Comments 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.
Cardinality 1..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:signer.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:signer.extension

Short Additional content defined by implementations
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.
Comments 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.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:signer.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value signer

Extension.extension:signer.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..1
Type Reference(Practitioner | PractitionerRole)
Invariants ele-1

Extension.extension:signedAt

Short When the requisition was signed -- a fully-qualified instant
Definition The moment the requisition was signed, as a timezone-qualified dateTime. This is the time of the signing write, which is not the same as ServiceRequest.authoredOn: authoring is preserved across an amendment while the signature is stamped afresh, so the two differ on any requisition that has been edited.
Comments 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.
Cardinality 1..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:signedAt.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:signedAt.extension

Short Additional content defined by implementations
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.
Comments 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.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:signedAt.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value signedAt

Extension.extension:signedAt.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..1
Type dateTime
Invariants ele-1

Extension.extension:stamp

Short LEGACY, read-only: identifier of a stored signature-stamp document
Definition The identifier of a stored document holding the signer's stamp image, as captured at sign time. Deprecated: no producer writes this, and none should. It is described because requisitions signed under an earlier shape still carry it and must keep rebuilding exactly as they did. Its absence says nothing about the validity of a signature -- an unstamped signature prints as the typed name and is fully valid.
Comments 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.
Cardinality 0..1
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:stamp.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:stamp.extension

Short Additional content defined by implementations
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.
Comments 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.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:stamp.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value stamp

Extension.extension:stamp.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..1
Type string
Invariants ele-1

Extension.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value ../StructureDefinition/nexus-requisition-signature

Extension.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..0
Type base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Invariants ele-1