DocumentHeader

CareConnect-Practitioner-1

CareConnect-Practitioner-1

Practitioner
Definition

A person who is directly or indirectly involved in the provisioning of healthcare.

Control 0..*
Type Practitioner
Comments

Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?

Practitioner.identifier(sdsUserId)
Definition

An identifier that applies to this person in this role.

Control 0..1
Type Identifier
Requirements

Often, specific identities are assigned for the agent.

Comments
Practitioner.identifier.system
Definition

Establishes the namespace in which set of possible id values is unique.

Control 1..1
Type Uri
Requirements

There are many sequences of identifiers. To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.

Comments
Fixed Value http://fhir.nhs.net/Id/sds-user-id
Practitioner.identifier.value
Definition

The portion of the identifier typically displayed to the user and which is unique within the context of the system.

Control 1..1
Type String
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.

Example 123456
Practitioner.identifier(sdsRoleProfileId)
Definition

An identifier that applies to this person in this role.

Control 0..*
Type Identifier
Requirements

Often, specific identities are assigned for the agent.

Comments
Practitioner.identifier.system
Definition

Establishes the namespace in which set of possible id values is unique.

Control 1..1
Type Uri
Requirements

There are many sequences of identifiers. To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.

Comments
Fixed Value http://fhir.nhs.net/Id/sds-user-id
Practitioner.identifier.value
Definition

The portion of the identifier typically displayed to the user and which is unique within the context of the system.

Control 1..1
Type String
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.

Example 123456
Practitioner.active
Definition

Whether this practitioner's record is in active use.

Control 0..1
Type Boolean
Requirements

Need to be able to mark a practitioner record as not to be used because it was created in error.

Comments

Default is true. If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.

Default Value true
Practitioner.name
Definition

A name associated with the person.

Control 1..1
Type HumanName
Requirements

Contact persons need to be identified by name, but it is uncommon to need details about multiple other names for that person.

Comments
Practitioner.name.family
Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Control 1..1
Type String
Aliases surname
Comments

For family name, hyphenated names such as "Smith-Jones" are a single name, but names with spaces such as "Smith Jones" are broken into multiple parts.

Practitioner.name.given
Definition

Given name.

Control 0..*
Type String
Aliases first name, middle name
Comments

If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.

Practitioner.name.prefix
Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Control 0..1
Type String
Comments
Practitioner.name.suffix
Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Control 0..1
Type String
Comments
Practitioner.telecom
Definition

A contact detail for the practitioner, e.g. a telephone number or an email address.

Control 0..*
Type ContactPoint
Requirements

Need to know how to reach a practitioner.

Comments

Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

Practitioner.telecom.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control 0..1 ?
Binding

Telecommunications form for contact point

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/contact-point-system

Type Code
Comments
Practitioner.telecom.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control 0..1
Type String
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

Practitioner.telecom.use
Definition

Identifies the purpose for the contact point.

Control 0..1
Binding

Use of contact point

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/contact-point-use

Type Code
Is Modifier True
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one. Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

Practitioner.telecom.rank
Definition

Specifies a preferred order in which to use a set of contacts. Contacts are ranked with lower values coming before higher values.

Control 0..1
Type PositiveInt
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

Practitioner.telecom.period
Definition

Time period when the contact point was/is in use.

Control 0..1
Type Period
Comments
Practitioner.telecom.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Practitioner.telecom.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Practitioner.address
Definition

The postal address where the practitioner can be found or visited or to which mail can be delivered.

Control 0..*
Type Address
Requirements

Need to keep track where the practitioner can found during work or for directing mail.

Comments
Practitioner.address.use
Definition

The purpose of this address.

Control 0..1
Binding

The use of an address

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/address-use

Type Code
Is Modifier True
Requirements

Allows an appropriate address to be chosen from a list of many.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Example home
Practitioner.address.type
Definition

Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

Control 0..1
Binding

The type of an address (physical / postal)

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/address-type

Type Code
Comments
Example both
Practitioner.address.text
Definition

A full text representation of the address.

Control 0..1
Type String
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts.

Example 137 Nowhere Street, Erewhon 9132
Practitioner.address.line
Definition

This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

Control 0..*
Type String
Requirements

home | work | temp | old - purpose of this address.

Comments
Example 137 Nowhere Street
Practitioner.address.city
Definition

The name of the city, town, village or other community or delivery center.

Control 0..1
Type String
Aliases Municpality
Comments
Example Erewhon
Practitioner.address.district
Definition

The name of the administrative area (county).

Control 0..1
Type String
Aliases County
Comments

District is sometimes known as county, but in some regions 'county' in used in place of city (municipality), so county name should be conveyed in city instead.

Example Madison
Practitioner.address.postalCode
Definition

A postal code designating a region defined by the postal service.

Control 0..1
Type String
Aliases Zip
Comments
Example 9132
Practitioner.address.country
Definition

Country - a nation as commonly understood or generally accepted.

Control 0..1
Type String
Comments

ISO 3166 3 letter codes can be used in place of a full country name.

Practitioner.address.period
Definition

Time period when address was/is in use.

Control 0..1
Type Period
Requirements

Allows addresses to be placed in historical context.

Comments
Example Hl7.Fhir.Model.Period
Practitioner.address.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Practitioner.address.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Practitioner.gender
Definition

Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

Control 0..1
Binding

The gender of a person used for administrative purposes.

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/administrative-gender

Type Code
Requirements

Needed to address the person correctly.

Comments
Practitioner.birthDate
Definition

The date of birth for the practitioner.

Control 0..1
Type Date
Requirements

Needed for identification.

Comments
Practitioner.photo
Definition

Image of the person.

Control 0..*
Type Attachment
Requirements

Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.

Comments
Practitioner.photo.contentType
Definition

Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

Control 0..1
Binding

The mime type of an attachment. Any valid mime type is allowed.

The codes SHALL be taken from http://www.rfc-editor.org/bcp/bcp13.txt

Type Code
Requirements

Processors of the data need to be able to know how to interpret the data.

Comments
Example text/plain; charset=UTF-8, image/png
Practitioner.photo.language
Definition

The human language of the content. The value can be any valid value according to BCP 47.

Control 0..1
Binding

A human language.

The codes SHALL be taken from http://tools.ietf.org/html/bcp47

Type Code
Requirements

Users need to be able to choose between the languages in a set of attachments.

Comments
Example en-AU
Practitioner.photo.data
Definition

The actual data of the attachment - a sequence of bytes. In XML, represented using base64.

Control 0..1
Type Base64Binary
Requirements

The data needs to able to be transmitted inline.

Comments

The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

Practitioner.photo.url
Definition

An alternative location where the data can be accessed.

Control 0..1
Type Uri
Requirements

The data needs to be transmitted by reference.

Comments

If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

Example http://www.acme.com/logo-small.png
Practitioner.photo.size
Definition

The number of bytes of data that make up this attachment.

Control 0..1
Type UnsignedInt
Requirements

Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

Comments

The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

Practitioner.photo.hash
Definition

The calculated hash of the data using SHA-1. Represented using base64.

Control 0..1
Type Base64Binary
Requirements

Included so that applications can verify that the contents of a location have not changed and so that a signature of the content can implicitly sign the content of an image without having to include the data in the instance or reference the url in the signature.

Comments
Practitioner.photo.title
Definition

A label or set of text to display in place of the data.

Control 0..1
Type String
Requirements

Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

Comments
Example Official Corporate Logo
Practitioner.photo.creation
Definition

The date that the attachment was first created.

Control 0..1
Type DateTime
Requirements

This is often tracked as an integrity issue for use of the attachment.

Comments
Practitioner.practitionerRole
Definition

The list of roles/organizations that the practitioner is associated with.

Control 0..*
Type BackboneElement
Comments
Practitioner.practitionerRole.modifierExtension
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control 0..*
Type Extension
Is Modifier True
Aliases extensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Practitioner.practitionerRole.managingOrganization
Definition

The organization where the Practitioner performs the roles associated.

Control 0..1
Comments
Practitioner.practitionerRole.managingOrganization.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Practitioner.practitionerRole.managingOrganization.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Practitioner.practitionerRole.role
Definition

Roles which this practitioner is authorized to perform for the organization.

Control 0..1
Binding

The role a person plays representing an organization

For example codes, see http://hl7.org/fhir/ValueSet/practitioner-role

; other codes may be used where these codes are not suitable
Type CodeableConcept
Requirements

Need to know what authority the practitioner has - what can they do?

Comments

A person may have more than one role. At least one role is required.

Practitioner.practitionerRole.role.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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 labelled as UserSelected = true.

Practitioner.practitionerRole.role.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

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 de-reference to some definition that establish the system clearly and unambiguously.

Practitioner.practitionerRole.role.coding.version
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.

Control 0..1
Type String
Comments

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.

Practitioner.practitionerRole.role.coding.code
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).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Practitioner.practitionerRole.role.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Practitioner.practitionerRole.role.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
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.

Comments

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.

Practitioner.practitionerRole.role.text
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.

Control 0..1
Type String
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.

Comments

Very often the text is the same as a displayName of one of the codings.

Practitioner.practitionerRole.specialty
Definition

Specific specialty of the practitioner.

Control 0..*
Binding

Specific specialty associated with the agency

For example codes, see http://hl7.org/fhir/ValueSet/practitioner-specialty

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments
Practitioner.practitionerRole.specialty.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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 labelled as UserSelected = true.

Practitioner.practitionerRole.specialty.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

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 de-reference to some definition that establish the system clearly and unambiguously.

Practitioner.practitionerRole.specialty.coding.version
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.

Control 0..1
Type String
Comments

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.

Practitioner.practitionerRole.specialty.coding.code
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).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Practitioner.practitionerRole.specialty.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Practitioner.practitionerRole.specialty.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
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.

Comments

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.

Practitioner.practitionerRole.specialty.text
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.

Control 0..1
Type String
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.

Comments

Very often the text is the same as a displayName of one of the codings.

Practitioner.practitionerRole.period
Definition

The period during which the person is authorized to act as a practitioner in these role(s) for the organization.

Control 0..1
Type Period
Requirements

Even after the agencies is revoked, the fact that it existed must still be recorded.

Comments
Practitioner.practitionerRole.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Practitioner.practitionerRole.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Practitioner.practitionerRole.location
Definition

The location(s) at which this practitioner provides care.

Control 0..*
Comments
Practitioner.practitionerRole.location.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Practitioner.practitionerRole.location.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Practitioner.practitionerRole.healthcareService
Definition

The list of healthcare services that this worker provides for this role's Organization/Location(s).

Control 0..*
Type HealthcareService
Comments
Practitioner.practitionerRole.healthcareService.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Practitioner.practitionerRole.healthcareService.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Practitioner.qualification
Definition

Qualifications obtained by training and certification.

Control 0..*
Type BackboneElement
Comments
Practitioner.qualification.modifierExtension
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control 0..*
Type Extension
Is Modifier True
Aliases extensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Practitioner.qualification.identifier
Definition

An identifier that applies to this person's qualification in this role.

Control 0..*
Type Identifier
Requirements

Often, specific identities are assigned for the qualification.

Comments
Practitioner.qualification.identifier.use
Definition

The purpose of this identifier.

Control 0..1
Binding

Identifies the purpose for this identifier, if known .

The codes SHALL be taken from http://hl7.org/fhir/ValueSet/identifier-use

Type Code
Is Modifier True
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Practitioner.qualification.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control 0..1
Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

The codes SHALL be taken from the following if appropriate, otherwise an alternate coding may be included instead. http://hl7.org/fhir/ValueSet/identifier-type

Type CodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

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.

Practitioner.qualification.identifier.type.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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 labelled as UserSelected = true.

Practitioner.qualification.identifier.type.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

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 de-reference to some definition that establish the system clearly and unambiguously.

Practitioner.qualification.identifier.type.coding.version
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.

Control 0..1
Type String
Comments

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.

Practitioner.qualification.identifier.type.coding.code
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).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Practitioner.qualification.identifier.type.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Practitioner.qualification.identifier.type.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
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.

Comments

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.

Practitioner.qualification.identifier.type.text
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.

Control 0..1
Type String
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.

Comments

Very often the text is the same as a displayName of one of the codings.

Practitioner.qualification.identifier.system
Definition

Establishes the namespace in which set of possible id values is unique.

Control 0..1
Type Uri
Requirements

There are many sequences of identifiers. To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.

Comments
Example http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Practitioner.qualification.identifier.value
Definition

The portion of the identifier typically displayed to the user and which is unique within the context of the system.

Control 0..1
Type String
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.

Example 123456
Practitioner.qualification.identifier.period
Definition

Time period during which identifier is/was valid for use.

Control 0..1
Type Period
Comments
Practitioner.qualification.identifier.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Practitioner.qualification.identifier.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Practitioner.qualification.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control 0..1
Type Organization
Comments

The reference may be just a text description of the assigner.

Practitioner.qualification.identifier.assigner.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Practitioner.qualification.identifier.assigner.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Practitioner.qualification.code
Definition

Coded representation of the qualification.

Control 1..1
Binding

Specific qualification the practitioner has to provide a service

For example codes, see http://hl7.org/fhir/ValueSet/anzsco-occupations

; other codes may be used where these codes are not suitable
Type CodeableConcept
Comments
Practitioner.qualification.code.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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 labelled as UserSelected = true.

Practitioner.qualification.code.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 0..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

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 de-reference to some definition that establish the system clearly and unambiguously.

Practitioner.qualification.code.coding.version
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.

Control 0..1
Type String
Comments

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.

Practitioner.qualification.code.coding.code
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).

Control 0..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Practitioner.qualification.code.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Practitioner.qualification.code.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control 0..1
Type Boolean
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.

Comments

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.

Practitioner.qualification.code.text
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.

Control 0..1
Type String
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.

Comments

Very often the text is the same as a displayName of one of the codings.

Practitioner.qualification.period
Definition

Period during which the qualification is valid.

Control 0..1
Type Period
Requirements

Qualifications are often for a limited period of time, and can be revoked.

Comments
Practitioner.qualification.period.start
Definition

The start of the period. The boundary is inclusive.

Control 0..1 ?
Type DateTime
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Practitioner.qualification.period.end
Definition

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

Control 0..1 ?
Type DateTime
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Practitioner.qualification.issuer
Definition

Organization that regulates and issues the qualification.

Control 0..1
Comments
Practitioner.qualification.issuer.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Control 0..1 ?
Type String
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Practitioner.qualification.issuer.display
Definition

Plain text narrative that identifies the resource in addition to the resource reference.

Control 0..1
Type String
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Practitioner.communication
Definition

A language the practitioner is able to use in patient communication.

Control 0..*
Binding

Human Language

The codes SHALL be taken from http://hl7.org.uk/CareConnect-HumanLanguage-1-VS

Type CodeableConcept
Requirements

Knowing which language a practitioner speaks can help in facilitating communication with patients.

Comments

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Practitioner.communication.coding
Definition

A reference to a code defined by a terminology system.

Control 0..*
Type Coding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

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 labelled as UserSelected = true.

Practitioner.communication.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control 1..1
Type Uri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

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 de-reference to some definition that establish the system clearly and unambiguously.

Fixed Value http://hl7.org.uk/fhir/ValueSet/CareConnect-HumanLanguage
Practitioner.communication.coding.code
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).

Control 1..1
Type Code
Requirements

Need to refer to a particular code in the system.

Comments
Practitioner.communication.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control 0..1
Type String
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Comments
Practitioner.communication.text
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.

Control 0..1
Type String
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.

Comments

Very often the text is the same as a displayName of one of the codings.