{ "resourceType": "StructureDefinition", "id": "nexus-statement-of-disagreement", "extension": [ { "url": "https://fhir.apps.health/StructureDefinition/effective-date", "extension": [ { "url": "paths", "valueString": "sent" } ] }, { "url": "https://fhir.apps.health/StructureDefinition/salient-field", "extension": [ { "url": "key", "valueCode": "status" }, { "url": "expression", "valueString": "status" }, { "url": "type", "valueCode": "code" } ] }, { "url": "https://fhir.apps.health/StructureDefinition/salient-field", "extension": [ { "url": "key", "valueCode": "category" }, { "url": "expression", "valueString": "category" }, { "url": "type", "valueCode": "coded" } ] }, { "url": "https://fhir.apps.health/StructureDefinition/salient-field", "extension": [ { "url": "key", "valueCode": "date" }, { "url": "expression", "valueString": "sent | received" }, { "url": "type", "valueCode": "dateTime" } ] } ], "url": "https://fhir.apps.health/StructureDefinition/nexus-statement-of-disagreement", "name": "NexusStatementOfDisagreement", "title": "Statement of Disagreement Profile", "status": "draft", "experimental": true, "description": "The individual's own statement about information they asked to have corrected and the custodian\nrefused to correct.\n\nWhere PHIPA gives a right to require that a statement of disagreement be attached to the record,\nthis is the resource that holds it. The statement is the individual's words, disclosed as written.\n\n**The obligation outlives the workflow.** Once attached, the statement must accompany the disputed\ninformation every time that information is disclosed -- through the API, in a printed chart, in a\nreferral packet, in a generated summary -- for as long as the record exists. Closing the\ncorrection Task does not end this. Nothing in FHIR enforces it: a release path must read the\nstatement's associations and assemble accordingly, and one that cannot carry the statement must\nrefuse the disclosure rather than send the disputed information alone.\n\n⚠ FIRST PASS. No release path in this estate currently consults these associations.", "fhirVersion": "4.0.1", "mapping": [ { "identity": "workflow", "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern" }, { "identity": "w5", "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" } ], "kind": "resource", "abstract": false, "type": "Communication", "baseDefinition": "https://fhir.apps.health/StructureDefinition/nexus-emr-core-communication", "derivation": "constraint", "snapshot": { "element": [ { "id": "Communication", "path": "Communication", "short": "The individual's statement about a refused correction, attached to the disputed record", "definition": "A message about a patient. Either WELL-internal staff chat, or eReferral correspondence\nexchanged with an external partner. `category` distinguishes them and readers should scope\non it -- the two populations have different authorities over their content.", "min": 0, "max": "*", "base": { "path": "Communication", "min": 0, "max": "*" }, "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-3", "severity": "error", "human": "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", "expression": "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()", "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-5", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a security label", "expression": "contained.meta.security.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:security))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation", "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." } ], "key": "dom-6", "severity": "warning", "human": "A resource should have narrative for robust management", "expression": "text.`div`.exists()", "xpath": "exists(f:text/h:div)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "nexus-note-extension-not-where-native", "severity": "error", "human": "The resource-note extension is not used on a resource that has a native `note` element -- that element is the home", "expression": "extension('https://fhir.apps.health/StructureDefinition/nexus-emr-resource-note').empty()", "source": "https://fhir.apps.health/StructureDefinition/nexus-emr-core-communication" }, { "key": "communication-has-category", "severity": "warning", "human": "SHOULD carry a category identifying which population this Communication belongs to (internal chat vs external eReferral traffic) -- the two are otherwise indistinguishable to a reader", "expression": "category.exists()", "source": "https://fhir.apps.health/StructureDefinition/nexus-emr-core-communication" }, { "key": "disagreement-names-disputed-record", "severity": "error", "human": "A statement of disagreement MUST reference the record it disputes, through the `disputes` slice of `about`. A statement with no target cannot be included with the information it concerns, which is the entire obligation it exists to satisfy", "expression": "about.exists()", "source": "https://fhir.apps.health/StructureDefinition/nexus-statement-of-disagreement" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "workflow", "map": "Event" } ] }, { "id": "Communication.id", "path": "Communication.id", "short": "Logical id of this artifact", "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.", "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.", "min": 0, "max": "1", "base": { "path": "Resource.id", "min": 0, "max": "1" }, "type": [ { "code": "http://hl7.org/fhirpath/System.String", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ] } ], "isModifier": false, "isSummary": true }, { "id": "Communication.meta", "path": "Communication.meta", "short": "Metadata about the resource", "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.", "min": 0, "max": "1", "base": { "path": "Resource.meta", "min": 0, "max": "1" }, "type": [ { "code": "Meta" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "Communication.meta.id", "path": "Communication.meta.id", "representation": [ "xmlAttr" ], "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.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "http://hl7.org/fhirpath/System.String", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ] } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.meta.extension", "path": "Communication.meta.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "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.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.meta.versionId", "path": "Communication.meta.versionId", "short": "Version specific identifier", "definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.", "comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.", "min": 0, "max": "1", "base": { "path": "Meta.versionId", "min": 0, "max": "1" }, "type": [ { "code": "id" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "Communication.meta.lastUpdated", "path": "Communication.meta.lastUpdated", "short": "When the resource version last changed", "definition": "When the resource last changed - e.g. when the version changed.", "comment": "This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http.html#read) interaction.", "min": 0, "max": "1", "base": { "path": "Meta.lastUpdated", "min": 0, "max": "1" }, "type": [ { "code": "instant" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "Communication.meta.source", "path": "Communication.meta.source", "short": "Identifies EMR instance & pipeline version the resource came from", "definition": "A URI that identifies the EMR pipeline and version from which this resource originated. This tells you which EMR instance (recommend using the instance identifier), and the version of the pipeline code/transformations.", "comment": "In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.", "min": 0, "max": "1", "base": { "path": "Meta.source", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true }, { "id": "Communication.meta.profile", "path": "Communication.meta.profile", "short": "Profiles this resource claims to conform to", "definition": "A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).", "comment": "It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.", "min": 0, "max": "*", "base": { "path": "Meta.profile", "min": 0, "max": "*" }, "type": [ { "code": "canonical", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/StructureDefinition" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "Communication.meta.security", "path": "Communication.meta.security", "short": "Security Labels applied to this resource", "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.", "comment": "The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.", "min": 0, "max": "*", "base": { "path": "Meta.security", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "SecurityLabels" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding", "valueBoolean": true } ], "strength": "extensible", "description": "Security Labels from the Healthcare Privacy and Security Classification System.", "valueSet": "http://hl7.org/fhir/ValueSet/security-labels" } }, { "id": "Communication.meta.tag", "path": "Communication.meta.tag", "short": "Tags applied to this resource", "definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.", "comment": "The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.", "min": 0, "max": "*", "base": { "path": "Meta.tag", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Tags" } ], "strength": "example", "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\".", "valueSet": "http://hl7.org/fhir/ValueSet/common-tags" } }, { "id": "Communication.implicitRules", "path": "Communication.implicitRules", "short": "A set of rules under which this content was created", "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.", "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.", "min": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": true, "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation", "isSummary": true }, { "id": "Communication.language", "path": "Communication.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).", "min": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Language" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding", "valueBoolean": true } ], "strength": "preferred", "description": "A human language.", "valueSet": "http://hl7.org/fhir/ValueSet/languages" } }, { "id": "Communication.text", "path": "Communication.text", "short": "Narrative", "definition": "A human-readable narrative summary of the NexusEmrCoreCommunication resource for human interpretation.", "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 0, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "1" }, "type": [ { "code": "Narrative" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "Act.text?" } ] }, { "id": "Communication.contained", "path": "Communication.contained", "short": "Contained, inline Resources", "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.", "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.", "alias": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "Communication.extension", "path": "Communication.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 resource. 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.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "Communication.modifierExtension", "path": "Communication.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "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.", "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them", "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "Communication.identifier", "path": "Communication.identifier", "short": "Business identifier(s) for the communication", "definition": "Unique identifiers for the communication.\n\nA business identifier is recommended but not required (identifier is 0..*). For eReferral traffic this is where the partner's own message identifier belongs -- it is the only governed way to correlate a reply with what it replies to across the boundary.\n\n⚠ HERITAGE EMR SITUATION -- UNRESOLVED. Heritage EMRs have internal messaging and inbox features, but they are NOT modelled as FHIR Communication: they are local message tables with their own threading, read/unread state, and per-user routing that has no FHIR equivalent. Nothing currently maps them into this resource. Two consequences: (1) a heritage-sourced message has no identifier this IG can name, so any ingest would have to mint one, and (2) migrating that history at all is an open decision -- the alternative is to leave heritage messages in the source system and have this resource cover only natively-authored traffic. Until that is decided, treat every Communication here as either WELL-internal-native or external eReferral, never heritage-migrated.\n\nIf no recognized system exists, implementers MAY invent a URI for the system.\n\nA source system's own identifier SHOULD be carried alongside this one, flagged `use = secondary`. See [Carrying the raw code](https://fhir.apps.health/guide/patterns/raw-codes.html).", "comment": "This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.", "requirements": "Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.", "min": 0, "max": "*", "base": { "path": "Communication.identifier", "min": 0, "max": "*" }, "type": [ { "code": "Identifier" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.identifier" }, { "identity": "w5", "map": "FiveWs.identifier" } ] }, { "id": "Communication.identifier.id", "path": "Communication.identifier.id", "representation": [ "xmlAttr" ], "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.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "http://hl7.org/fhirpath/System.String", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ] } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.identifier.extension", "path": "Communication.identifier.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "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.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.identifier.use", "path": "Communication.identifier.use", "short": "usual | official | temp | secondary | old (If known)", "definition": "The purpose of this identifier.", "comment": "Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.", "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.", "min": 0, "max": "1", "base": { "path": "Identifier.use", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": true, "isModifierReason": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one.", "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "IdentifierUse" } ], "strength": "required", "description": "Identifies the purpose for this identifier, if known .", "valueSet": "http://hl7.org/fhir/ValueSet/identifier-use|4.0.1" }, "mapping": [ { "identity": "v2", "map": "N/A" }, { "identity": "rim", "map": "Role.code or implied by context" } ] }, { "id": "Communication.identifier.type", "path": "Communication.identifier.type", "short": "Description of identifier", "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.", "comment": "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.", "requirements": "Allows users to make use of identifiers when the identifier system is not known.", "min": 0, "max": "1", "base": { "path": "Identifier.type", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "IdentifierType" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding", "valueBoolean": true } ], "strength": "extensible", "description": "A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.", "valueSet": "http://hl7.org/fhir/ValueSet/identifier-type" }, "mapping": [ { "identity": "v2", "map": "CX.5" }, { "identity": "rim", "map": "Role.code or implied by context" } ] }, { "id": "Communication.identifier.system", "path": "Communication.identifier.system", "short": "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.", "comment": "Identifier.system is always case sensitive.", "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.", "min": 1, "max": "1", "base": { "path": "Identifier.system", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "example": [ { "label": "General", "valueUri": "http://www.acme.com/identifiers/patient" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "CX.4 / EI-2-4" }, { "identity": "rim", "map": "II.root or Role.id.root" }, { "identity": "servd", "map": "./IdentifierType" } ] }, { "id": "Communication.identifier.value", "path": "Communication.identifier.value", "short": "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.", "comment": "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](extension-rendered-value.html). 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.", "min": 1, "max": "1", "base": { "path": "Identifier.value", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "example": [ { "label": "General", "valueString": "123456" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "CX.1 / EI.1" }, { "identity": "rim", "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)" }, { "identity": "servd", "map": "./Value" } ] }, { "id": "Communication.identifier.period", "path": "Communication.identifier.period", "short": "Time period when id is/was valid for use", "definition": "Time period during which identifier is/was valid for use.", "min": 0, "max": "1", "base": { "path": "Identifier.period", "min": 0, "max": "1" }, "type": [ { "code": "Period" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "CX.7 + CX.8" }, { "identity": "rim", "map": "Role.effectiveTime or implied by context" }, { "identity": "servd", "map": "./StartDate and ./EndDate" } ] }, { "id": "Communication.identifier.assigner", "path": "Communication.identifier.assigner", "short": "Organization that issued id (may be just text)", "definition": "Organization that issued/manages the identifier.", "comment": "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.", "min": 0, "max": "1", "base": { "path": "Identifier.assigner", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "CX.4 / (CX.4,CX.9,CX.10)" }, { "identity": "rim", "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper" }, { "identity": "servd", "map": "./IdentifierIssuingAuthority" } ] }, { "id": "Communication.instantiatesCanonical", "path": "Communication.instantiatesCanonical", "short": "Instantiates FHIR protocol or definition", "definition": "The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.", "min": 0, "max": "*", "base": { "path": "Communication.instantiatesCanonical", "min": 0, "max": "*" }, "type": [ { "code": "canonical", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/PlanDefinition", "http://hl7.org/fhir/StructureDefinition/ActivityDefinition", "http://hl7.org/fhir/StructureDefinition/Measure", "http://hl7.org/fhir/StructureDefinition/OperationDefinition", "http://hl7.org/fhir/StructureDefinition/Questionnaire" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.instantiatesCanonical" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=DEFN].target" } ] }, { "id": "Communication.instantiatesUri", "path": "Communication.instantiatesUri", "short": "Instantiates external protocol or definition", "definition": "The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.", "comment": "This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.", "min": 0, "max": "*", "base": { "path": "Communication.instantiatesUri", "min": 0, "max": "*" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.instantiatesUri" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=DEFN].target" } ] }, { "id": "Communication.basedOn", "path": "Communication.basedOn", "short": "Request fulfilled by this communication", "definition": "An order, proposal or plan fulfilled in whole or in part by this Communication.", "comment": "This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc.", "alias": [ "fulfills" ], "min": 0, "max": "*", "base": { "path": "Communication.basedOn", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.basedOn" } ] }, { "id": "Communication.partOf", "path": "Communication.partOf", "short": "The correction request that was refused", "definition": "The clinical Task that carried the correction request through to its refusal -- the one whose\n`businessStatus` reached `denied`. Where the producer declares it, that Task is a\n[correction task](https://fhir.apps.health/fhir/StructureDefinition-nexus-correction-task.html); this element does not require the\ndeclaration, because nothing in this estate writes `meta.profile` onto a Task today.\n\nThis is the audit trail: it names who decided, when, and on what stated reason. It is NOT how a\nrelease path finds this statement. Disclosure assembly reads `about`, because the obligation\nattaches to the clinical record rather than to the workflow, and the workflow closes.\n\nHL7's Patient Request for Corrections guide carries the Task association in an `about` slice and\nuses `partOf` for message threading. This guide reverses that, so that `about` holds only the\ndisputed records and a release path can read it without filtering. A consumer converting between\nthe two must move the reference rather than copy it.", "alias": [ "container" ], "min": 0, "max": "1", "base": { "path": "Communication.partOf", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-clinical-task" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.partOf" } ] }, { "id": "Communication.inResponseTo", "path": "Communication.inResponseTo", "short": "The custodian's notice of refusal, where one was sent", "definition": "The Communication in which the custodian told the individual their correction request was refused. Optional, and its absence says nothing about whether the refusal was communicated -- it may have been given verbally or on paper.", "comment": "⚠ FIRST PASS. The chat panel currently threads by neither `inResponseTo` nor `partOf` -- conversation order is reconstructed from timestamps, which is why concurrent messages can interleave wrongly. Declaring the element here is the first step; deciding whether threads are `inResponseTo` chains or a `partOf` grouping is open.", "min": 0, "max": "*", "base": { "path": "Communication.inResponseTo", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-communication" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false }, { "id": "Communication.status", "path": "Communication.status", "short": "completed once the statement has been recorded", "definition": "The lifecycle of the MESSAGE, not of the obligation. `completed` means the statement was received\nand recorded. It does not mean the matter is closed, and it has no bearing on whether the\nstatement must still be included in a disclosure -- it must.\n\n`entered-in-error` is the only route to withdrawing a statement, and it must be used only where\nthe statement was recorded in error. An individual who wishes to change their statement supplies a\nnew one; the original remains in version history, because a custodian deleting an individual's\naccount of a dispute is the shape of the problem the right exists to prevent.", "comment": "Internal chat writes `completed` on send. For eReferral traffic the partner's lifecycle applies and `status` is pass-through -- do not infer local workflow state from it.", "min": 1, "max": "1", "base": { "path": "Communication.status", "min": 1, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": true, "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid", "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CommunicationStatus" } ], "strength": "required", "description": "The status of the communication.", "valueSet": "http://hl7.org/fhir/ValueSet/event-status|4.0.1" }, "mapping": [ { "identity": "workflow", "map": "Event.status" }, { "identity": "w5", "map": "FiveWs.status" } ] }, { "id": "Communication.statusReason", "path": "Communication.statusReason", "short": "Reason for current status", "definition": "Captures the reason for the current state of the Communication.", "comment": "This is generally only used for \"exception\" statuses such as \"not-done\", \"suspended\" or \"aborted\". The reason for performing the event at all is captured in reasonCode, not here.", "alias": [ "Suspended Reason", "Cancelled Reason" ], "min": 0, "max": "1", "base": { "path": "Communication.statusReason", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CommunicationNotDoneReason" } ], "strength": "example", "description": "Codes for the reason why a communication did not happen.", "valueSet": "http://hl7.org/fhir/ValueSet/communication-not-done-reason" }, "mapping": [ { "identity": "workflow", "map": "Event.statusReason" } ] }, { "id": "Communication.category", "path": "Communication.category", "slicing": { "discriminator": [ { "type": "pattern", "path": "coding.system" } ], "rules": "open", "description": "Slice the disagreement-identifying category by code system" }, "short": "MUST identify this as a disagreement statement", "definition": "Carries the HL7 correction vocabulary's disagreement code, so that a consumer scanning a patient's\nCommunications can find every statement of disagreement without knowing this guide's profile URL.\n\nThe parent profile leaves `category` unbound and text-tolerant. This profile requires a coded one,\nbecause a statement nobody can find is a statement nobody will include.", "comment": "⚠ FIRST PASS -- no value set is bound yet, deliberately. Binding one requires deciding the pass-through boundary first (a partner-supplied category must remain conformant), and that decision is not made. Until then this is text-or-code and readers MUST tolerate text-only. A local NexusEmrCommunicationCategoryVS is the intended follow-up.", "min": 1, "max": "*", "base": { "path": "Communication.category", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CommunicationCategory" } ], "strength": "example", "description": "Codes for general categories of communications such as alerts, instructions, etc.", "valueSet": "http://hl7.org/fhir/ValueSet/communication-category" }, "mapping": [ { "identity": "w5", "map": "FiveWs.class" } ] }, { "id": "Communication.category:disagreement", "path": "Communication.category", "sliceName": "disagreement", "short": "MUST identify this as a disagreement statement", "definition": "Carries the HL7 correction vocabulary's disagreement code, so that a consumer scanning a patient's\nCommunications can find every statement of disagreement without knowing this guide's profile URL.\n\nThe parent profile leaves `category` unbound and text-tolerant. This profile requires a coded one,\nbecause a statement nobody can find is a statement nobody will include.", "comment": "The code comes from HL7's Patient Request for Corrections COMMUNICATION type system, not its TASK\ntype system. Both publish a code spelled `medRecCxDenialDisagree`, at different canonical URLs. A\ncoding carrying the right code under the wrong system is not equivalent and a consumer matching on\ncode alone will not notice the difference.\n\nThe system is not resolvable in this build -- that package is deliberately not a dependency -- so\nterminology-aware validators will report that this code cannot be verified. That is expected.", "min": 1, "max": "1", "base": { "path": "Communication.category", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CommunicationCategory" } ], "strength": "example", "description": "Codes for general categories of communications such as alerts, instructions, etc.", "valueSet": "http://hl7.org/fhir/ValueSet/communication-category" }, "mapping": [ { "identity": "w5", "map": "FiveWs.class" } ] }, { "id": "Communication.category:disagreement.id", "path": "Communication.category.id", "representation": [ "xmlAttr" ], "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.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "http://hl7.org/fhirpath/System.String", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ] } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.category:disagreement.extension", "path": "Communication.category.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "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.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.category:disagreement.coding", "path": "Communication.category.coding", "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 1, "max": "1", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "Communication.category:disagreement.coding.id", "path": "Communication.category.coding.id", "representation": [ "xmlAttr" ], "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.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "http://hl7.org/fhirpath/System.String", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ] } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.category:disagreement.coding.extension", "path": "Communication.category.coding.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "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.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.category:disagreement.coding.system", "path": "Communication.category.coding.system", "short": "Identity of the terminology system", "definition": "The identification of the code system that defines the meaning of the symbol in the code.", "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.", "requirements": "Need to be unambiguous about the source of the definition of the symbol.", "min": 1, "max": "1", "base": { "path": "Coding.system", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "fixedUri": "http://hl7.org/fhir/uv/patient-corrections/CodeSystem/PatientCorrectionCommunicationTypes", "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.3" }, { "identity": "rim", "map": "./codeSystem" }, { "identity": "orim", "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" } ] }, { "id": "Communication.category:disagreement.coding.version", "path": "Communication.category.coding.version", "short": "Version of the system - if relevant", "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.", "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.", "min": 0, "max": "1", "base": { "path": "Coding.version", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.7" }, { "identity": "rim", "map": "./codeSystemVersion" }, { "identity": "orim", "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" } ] }, { "id": "Communication.category:disagreement.coding.code", "path": "Communication.category.coding.code", "short": "Symbol in syntax defined by the system", "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).", "requirements": "Need to refer to a particular code in the system.", "min": 1, "max": "1", "base": { "path": "Coding.code", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "fixedCode": "medRecCxDenialDisagree", "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1" }, { "identity": "rim", "map": "./code" }, { "identity": "orim", "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" } ] }, { "id": "Communication.category:disagreement.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Communication.category.coding.display", "short": "Representation defined by the system", "definition": "A representation of the meaning of the code in the system, following the rules of the system.", "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.", "min": 0, "max": "1", "base": { "path": "Coding.display", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.2 - but note this is not well followed" }, { "identity": "rim", "map": "CV.displayName" }, { "identity": "orim", "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" } ] }, { "id": "Communication.category:disagreement.coding.userSelected", "path": "Communication.category.coding.userSelected", "short": "If this coding was chosen directly by the user", "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).", "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.", "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.", "min": 0, "max": "1", "base": { "path": "Coding.userSelected", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "Sometimes implied by being first" }, { "identity": "rim", "map": "CD.codingRationale" }, { "identity": "orim", "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]" } ] }, { "id": "Communication.category:disagreement.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Communication.category.text", "short": "Plain text representation of the concept", "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "min": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "Communication.priority", "path": "Communication.priority", "short": "routine | urgent | asap | stat", "definition": "Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.", "comment": "Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.", "min": 0, "max": "1", "base": { "path": "Communication.priority", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "meaningWhenMissing": "If missing, this communication should be treated with normal priority", "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CommunicationPriority" } ], "strength": "required", "description": "Codes indicating the relative importance of a communication.", "valueSet": "http://hl7.org/fhir/ValueSet/request-priority|4.0.1" }, "mapping": [ { "identity": "w5", "map": "FiveWs.grade" } ] }, { "id": "Communication.medium", "path": "Communication.medium", "short": "A channel of communication", "definition": "A channel that was used for this communication (e.g. email, fax).", "min": 0, "max": "*", "base": { "path": "Communication.medium", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CommunicationMedium" } ], "strength": "example", "description": "Codes for communication mediums such as phone, fax, email, in person, etc.", "valueSet": "http://terminology.hl7.org/ValueSet/v3-ParticipationMode" } }, { "id": "Communication.subject", "path": "Communication.subject", "short": "The patient whose record is disputed", "definition": "The patient or group that was the focus of this communication.", "comment": "Tightened from the parent's 0..1. A statement of disagreement that is not scoped to a chart cannot be attached to one.", "alias": [ "patient" ], "min": 1, "max": "1", "base": { "path": "Communication.subject", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-patient" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.subject" }, { "identity": "w5", "map": "FiveWs.subject[x]" }, { "identity": "w5", "map": "FiveWs.subject" } ] }, { "id": "Communication.topic", "path": "Communication.topic", "short": "Description of the purpose/content", "definition": "Description of the purpose/content, similar to a subject line in an email.", "comment": "Communication.topic.text can be used without any codings.", "min": 0, "max": "1", "base": { "path": "Communication.topic", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CommunicationTopic" } ], "strength": "example", "description": "Codes describing the purpose or content of the communication.", "valueSet": "http://hl7.org/fhir/ValueSet/communication-topic" }, "mapping": [ { "identity": "w5", "map": "FiveWs.context" } ] }, { "id": "Communication.about", "path": "Communication.about", "short": "The disputed record(s) this statement attaches to", "definition": "The records whose disclosure must carry this statement. At least one is required: a statement with\nno target cannot be attached to anything, and a release path has nothing to test.\n\n**Version-pinned or not -- carry BOTH, and the reason matters.** A reference including a `_history`\nversion pins the exact content the individual disputed, which is what an auditor needs. But a\nversion-pinned reference alone will NOT cause a current-state export to include the statement,\nbecause a consumer assembling today's chart never looks at that version. Add an unversioned\nreference to the same logical record so the statement travels with whatever that record now says.\n\nA statement associated only with a superseded version stops being disclosed the moment the record\nis edited for any unrelated reason, and nothing reports that it has.", "comment": "Deliberately NOT sliced. Separating the disputed record from the workflow Task by reference target\ntype needs a discriminator that resolves the reference, which this guide's evaluable-slicing\nconvention avoids -- an unevaluable slice renders on the published page and then checks nothing.\nThe correction Task is carried on `partOf` instead, so the two associations sit on different\nelements and no discriminator is needed.", "min": 1, "max": "*", "base": { "path": "Communication.about", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "w5", "map": "FiveWs.context" } ] }, { "id": "Communication.encounter", "path": "Communication.encounter", "short": "Encounter created as part of", "definition": "The Encounter during which this Communication was created or to which the creation of this record is tightly associated.", "comment": "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.", "min": 0, "max": "1", "base": { "path": "Communication.encounter", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.context" }, { "identity": "w5", "map": "FiveWs.context" } ] }, { "id": "Communication.sent", "path": "Communication.sent", "short": "When the individual made the statement", "definition": "The time when this communication was sent.", "min": 1, "max": "1", "base": { "path": "Communication.sent", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.occurrence[x] {Invariant: maps to period.start}" }, { "identity": "w5", "map": "FiveWs.done[x]" } ] }, { "id": "Communication.received", "path": "Communication.received", "short": "When the message was received", "definition": "The time when this communication arrived at the destination.", "min": 0, "max": "1", "base": { "path": "Communication.received", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.occurrence[x] {Invariant: maps to period.end}" }, { "identity": "w5", "map": "FiveWs.done[x]" } ] }, { "id": "Communication.recipient", "path": "Communication.recipient", "short": "Who the message was addressed to", "definition": "The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).", "min": 0, "max": "*", "base": { "path": "Communication.recipient", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-practitioner", "https://fhir.apps.health/StructureDefinition/nexus-emr-core-practitionerrole", "https://fhir.apps.health/StructureDefinition/nexus-emr-core-patient", "https://fhir.apps.health/StructureDefinition/nexus-emr-core-relatedperson", "https://fhir.apps.health/StructureDefinition/nexus-emr-core-organization", "https://fhir.apps.health/StructureDefinition/nexus-emr-core-careteam" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.performer.actor" }, { "identity": "w5", "map": "FiveWs.actor" } ] }, { "id": "Communication.sender", "path": "Communication.sender", "short": "The individual, or their substitute decision-maker", "definition": "Who is making the statement. Narrowed from the parent profile to exactly these two, because the\nright of reply belongs to the individual and to nobody else.\n\n**A substitute decision-maker is a RelatedPerson.** Recording an SDM's statement as though the\npatient made it loses the fact that authority was delegated, which is precisely what gets checked\nwhen the statement is later challenged.", "comment": "Practitioner is the primary provider identity in this IG. Organization covers a partner-system sender on inbound eReferral traffic; Device covers system-generated messages. RelatedPerson covers a SUBSTITUTE DECISION-MAKER acting for the patient -- a distinct fact from the patient acting themselves, and one that must not be flattened onto Patient: where a right over the record is exercised by proxy, the record has to show that authority was delegated, because that is what is checked when the exercise is challenged.", "min": 1, "max": "1", "base": { "path": "Communication.sender", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-patient", "https://fhir.apps.health/StructureDefinition/nexus-emr-core-relatedperson" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.performer.actor" }, { "identity": "w5", "map": "FiveWs.actor" } ] }, { "id": "Communication.reasonCode", "path": "Communication.reasonCode", "short": "Indication for message", "definition": "The reason or justification for the communication.", "comment": "Textual reasons can be captured using reasonCode.text.", "min": 0, "max": "*", "base": { "path": "Communication.reasonCode", "min": 0, "max": "*" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CommunicationReason" } ], "strength": "example", "description": "Codes for describing reasons for the occurrence of a communication.", "valueSet": "http://hl7.org/fhir/ValueSet/clinical-findings" }, "mapping": [ { "identity": "workflow", "map": "Event.reasonCode" }, { "identity": "w5", "map": "FiveWs.why[x]" }, { "identity": "rim", "map": ".reasonCode" } ] }, { "id": "Communication.reasonReference", "path": "Communication.reasonReference", "short": "Why was communication done?", "definition": "Indicates another resource whose existence justifies this communication.", "min": 0, "max": "*", "base": { "path": "Communication.reasonReference", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition", "http://hl7.org/fhir/StructureDefinition/Observation", "http://hl7.org/fhir/StructureDefinition/DiagnosticReport", "http://hl7.org/fhir/StructureDefinition/DocumentReference" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "workflow", "map": "Event.reasonReference" }, { "identity": "w5", "map": "FiveWs.why[x]" }, { "identity": "rim", "map": ".outboundRelationship[typeCode=RSON].target" } ] }, { "id": "Communication.payload", "path": "Communication.payload", "short": "The statement itself, in the individual's own words", "definition": "The statement. Required, and at least one payload must carry the text.\n\n`contentString` for a statement given in writing or transcribed verbatim; `contentAttachment` or a\n`contentReference` to a DocumentReference for a signed letter the individual supplied.\n\n**Not summarised, not paraphrased, not edited.** The content is disclosed as the individual wrote\nit. A clinic that condenses a statement into a chart note has substituted its own account for the\none PHIPA entitles the individual to have carried.", "comment": "Internal chat writes `contentString`. eReferral traffic may carry `contentAttachment` or `contentReference` -- a reader that assumes contentString will silently render an empty message. Handle all three.", "min": 1, "max": "*", "base": { "path": "Communication.payload", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false }, { "id": "Communication.payload.id", "path": "Communication.payload.id", "representation": [ "xmlAttr" ], "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.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "http://hl7.org/fhirpath/System.String", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ] } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.payload.extension", "path": "Communication.payload.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.", "comment": "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Communication.payload.modifierExtension", "path": "Communication.payload.modifierExtension", "short": "Extensions that cannot be ignored even if unrecognized", "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "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.", "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "Communication.payload.content[x]", "path": "Communication.payload.content[x]", "short": "Message part content", "definition": "A communicated content (or for multi-part communications, one portion of the communication).", "min": 1, "max": "1", "base": { "path": "Communication.payload.content[x]", "min": 1, "max": "1" }, "type": [ { "code": "string" }, { "code": "Attachment" }, { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false }, { "id": "Communication.note", "path": "Communication.note", "short": "Comments made about the communication", "definition": "Additional notes or commentary about the communication by the sender, receiver or other interested parties.", "min": 0, "max": "*", "base": { "path": "Communication.note", "min": 0, "max": "*" }, "type": [ { "code": "Annotation" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "workflow", "map": "Event.note" } ] } ] }, "differential": { "element": [ { "id": "Communication", "path": "Communication", "short": "The individual's statement about a refused correction, attached to the disputed record", "constraint": [ { "key": "disagreement-names-disputed-record", "severity": "error", "human": "A statement of disagreement MUST reference the record it disputes, through the `disputes` slice of `about`. A statement with no target cannot be included with the information it concerns, which is the entire obligation it exists to satisfy", "expression": "about.exists()", "source": "https://fhir.apps.health/StructureDefinition/nexus-statement-of-disagreement" } ] }, { "id": "Communication.partOf", "path": "Communication.partOf", "short": "The correction request that was refused", "definition": "The clinical Task that carried the correction request through to its refusal -- the one whose\n`businessStatus` reached `denied`. Where the producer declares it, that Task is a\n[correction task](https://fhir.apps.health/fhir/StructureDefinition-nexus-correction-task.html); this element does not require the\ndeclaration, because nothing in this estate writes `meta.profile` onto a Task today.\n\nThis is the audit trail: it names who decided, when, and on what stated reason. It is NOT how a\nrelease path finds this statement. Disclosure assembly reads `about`, because the obligation\nattaches to the clinical record rather than to the workflow, and the workflow closes.\n\nHL7's Patient Request for Corrections guide carries the Task association in an `about` slice and\nuses `partOf` for message threading. This guide reverses that, so that `about` holds only the\ndisputed records and a release path can read it without filtering. A consumer converting between\nthe two must move the reference rather than copy it.", "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-clinical-task" ] } ], "mustSupport": true }, { "id": "Communication.inResponseTo", "path": "Communication.inResponseTo", "short": "The custodian's notice of refusal, where one was sent", "definition": "The Communication in which the custodian told the individual their correction request was refused. Optional, and its absence says nothing about whether the refusal was communicated -- it may have been given verbally or on paper." }, { "id": "Communication.status", "path": "Communication.status", "short": "completed once the statement has been recorded", "definition": "The lifecycle of the MESSAGE, not of the obligation. `completed` means the statement was received\nand recorded. It does not mean the matter is closed, and it has no bearing on whether the\nstatement must still be included in a disclosure -- it must.\n\n`entered-in-error` is the only route to withdrawing a statement, and it must be used only where\nthe statement was recorded in error. An individual who wishes to change their statement supplies a\nnew one; the original remains in version history, because a custodian deleting an individual's\naccount of a dispute is the shape of the problem the right exists to prevent." }, { "id": "Communication.category", "path": "Communication.category", "slicing": { "discriminator": [ { "type": "pattern", "path": "coding.system" } ], "rules": "open", "description": "Slice the disagreement-identifying category by code system" }, "short": "MUST identify this as a disagreement statement", "definition": "Carries the HL7 correction vocabulary's disagreement code, so that a consumer scanning a patient's\nCommunications can find every statement of disagreement without knowing this guide's profile URL.\n\nThe parent profile leaves `category` unbound and text-tolerant. This profile requires a coded one,\nbecause a statement nobody can find is a statement nobody will include.", "min": 1 }, { "id": "Communication.category:disagreement", "path": "Communication.category", "sliceName": "disagreement", "comment": "The code comes from HL7's Patient Request for Corrections COMMUNICATION type system, not its TASK\ntype system. Both publish a code spelled `medRecCxDenialDisagree`, at different canonical URLs. A\ncoding carrying the right code under the wrong system is not equivalent and a consumer matching on\ncode alone will not notice the difference.\n\nThe system is not resolvable in this build -- that package is deliberately not a dependency -- so\nterminology-aware validators will report that this code cannot be verified. That is expected.", "min": 1, "max": "1", "mustSupport": true }, { "id": "Communication.category:disagreement.coding", "path": "Communication.category.coding", "min": 1, "max": "1" }, { "id": "Communication.category:disagreement.coding.system", "path": "Communication.category.coding.system", "min": 1, "fixedUri": "http://hl7.org/fhir/uv/patient-corrections/CodeSystem/PatientCorrectionCommunicationTypes" }, { "id": "Communication.category:disagreement.coding.code", "path": "Communication.category.coding.code", "min": 1, "fixedCode": "medRecCxDenialDisagree" }, { "id": "Communication.subject", "path": "Communication.subject", "short": "The patient whose record is disputed", "comment": "Tightened from the parent's 0..1. A statement of disagreement that is not scoped to a chart cannot be attached to one.", "min": 1 }, { "id": "Communication.about", "path": "Communication.about", "short": "The disputed record(s) this statement attaches to", "definition": "The records whose disclosure must carry this statement. At least one is required: a statement with\nno target cannot be attached to anything, and a release path has nothing to test.\n\n**Version-pinned or not -- carry BOTH, and the reason matters.** A reference including a `_history`\nversion pins the exact content the individual disputed, which is what an auditor needs. But a\nversion-pinned reference alone will NOT cause a current-state export to include the statement,\nbecause a consumer assembling today's chart never looks at that version. Add an unversioned\nreference to the same logical record so the statement travels with whatever that record now says.\n\nA statement associated only with a superseded version stops being disclosed the moment the record\nis edited for any unrelated reason, and nothing reports that it has.", "comment": "Deliberately NOT sliced. Separating the disputed record from the workflow Task by reference target\ntype needs a discriminator that resolves the reference, which this guide's evaluable-slicing\nconvention avoids -- an unevaluable slice renders on the published page and then checks nothing.\nThe correction Task is carried on `partOf` instead, so the two associations sit on different\nelements and no discriminator is needed.", "min": 1, "mustSupport": true }, { "id": "Communication.sent", "path": "Communication.sent", "short": "When the individual made the statement", "min": 1 }, { "id": "Communication.sender", "path": "Communication.sender", "short": "The individual, or their substitute decision-maker", "definition": "Who is making the statement. Narrowed from the parent profile to exactly these two, because the\nright of reply belongs to the individual and to nobody else.\n\n**A substitute decision-maker is a RelatedPerson.** Recording an SDM's statement as though the\npatient made it loses the fact that authority was delegated, which is precisely what gets checked\nwhen the statement is later challenged.", "min": 1, "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-patient", "https://fhir.apps.health/StructureDefinition/nexus-emr-core-relatedperson" ] } ] }, { "id": "Communication.payload", "path": "Communication.payload", "short": "The statement itself, in the individual's own words", "definition": "The statement. Required, and at least one payload must carry the text.\n\n`contentString` for a statement given in writing or transcribed verbatim; `contentAttachment` or a\n`contentReference` to a DocumentReference for a signed letter the individual supplied.\n\n**Not summarised, not paraphrased, not edited.** The content is disclosed as the individual wrote\nit. A clinic that condenses a statement into a chart note has substituted its own account for the\none PHIPA entitles the individual to have carried.", "min": 1 } ] } }