eHealth Infrastructure (v2020.1)

StructureDefinition: ehealth-consent - Detailed Descriptions

Definitions for the ehealth-consent Profile.

1. Consent
Definition

A record of a healthcare consumer’s policy choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.

Control0..*
Comments

Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.

InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
ppc-1: Either a Policy or PolicyRule (: policy.exists() or policyRule.exists())
2. Consent.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

3. Consent.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
4. Consent.implicitRules
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.

Control0..1
Typeuri
Is Modifiertrue
Comments

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

5. Consent.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages
Typecode
Comments

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).

6. Consent.text
Definition

A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

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 in formation is added later.

7. Consent.contained
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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

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.

8. Consent.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

9. Consent.modifierExtension
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. 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

10. Consent.identifier
Definition

Unique identifier for this copy of the Consent Statement.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Comments

This identifier is identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.

Example
General:<valueIdentifier xmlns="http://hl7.org/fhir">
  <system value="urn:ietf:rfc:3986"/>
  <value value="Local eCMS identifier"/>
</valueIdentifier>
11. Consent.status
Definition

Indicates the current state of this consent.

Control1..1
BindingIndicates the state of the consent
The codes SHALL be taken from ConsentState
Typecode
Is Modifiertrue
Requirements

The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.

Comments

This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.

12. Consent.category
Definition

Type of consent. E.g. "Send address information to SSL provider". The Category can implicitly specify both action and data. In this example data is address information for the related Patient and the action is sending the address to an SSL provider.

The infrastructure will enforce consent rules based on the category.

Control1..*
BindingThe codes SHALL be taken from ConsentCategory
TypeCodeableConcept
13. Consent.category.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
14. Consent.category.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Consent.category.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
15. Consent.category.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
BindingValue set of kinds of consents.
The codes SHALL be taken from ConsentCategory
TypeCoding
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 labeled as UserSelected = true.

16. Consent.category.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.

Control0..1
Typestring
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.

17. Consent.patient
Definition

The patient/healthcare consumer to whom this consent applies.

Control1..1
TypeReference(ehealth-patient)
Comments

Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

18. Consent.period
Definition

Relevant time or time-period when this Consent is applicable.

Control1..1
TypePeriod
Comments

This can be a subset of the period of the original statement.

Meaning if Missingall date ranges included
19. Consent.period.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
20. Consent.period.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Consent.period.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
21. Consent.period.start
Definition

The start of the period. The boundary is inclusive.

Control1..1 This element is affected by the following invariants: per-1
TypedateTime
Comments

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

22. Consent.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.

Control0..1 This element is affected by the following invariants: per-1
TypedateTime
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.

Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
23. Consent.dateTime
Definition

When this Consent was issued / created / indexed.

Control0..1
TypedateTime
Comments

This is not the time of the original consent, but the time that this statement was made or derived.

24. Consent.consentingParty
Definition

Patient or related person (e.g. guardian) consenting on behalf of the patient. Receiving organisation of the consent.

Control1..*
TypeReference(ehealth-organization | ehealth-patient | ehealth-practitioner | ehealth-relatedperson)
Alternate Namesconsentor
Comments

Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.

Patient or related person (eg guardian) consenting on behalf of the patient. Receiving organisation of the consent.

25. Consent.actor
Definition

Who or what is controlled by this consent. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

Control1..*
TypeBackboneElement
Comments

Careteam/organisation that is authorized to forward information by this consent.

Meaning if MissingThere is no specific actor associated with the consent
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
26. Consent.actor.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
27. Consent.actor.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

28. Consent.actor.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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

29. Consent.actor.role
Definition

How the individual is involved in the resources content that is described in the consent.

Control1..1
BindingHow an actor is involved in the consent considerations
The codes SHALL be taken from SecurityRoleType; other codes may be used where these codes are not suitable
TypeCodeableConcept
30. Consent.actor.reference
Definition

The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').

Control1..1
TypeReference(ehealth-device | Group | ehealth-careteam | ehealth-organization | ehealth-patient | ehealth-practitioner | ehealth-relatedperson)
31. Consent.action
Definition

Actions controlled by this consent.

Control0..*
BindingDetailed codes for the consent action.
For example codes, see Consent Action Codes
TypeCodeableConcept
Comments

Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.

Meaning if Missingall actions
32. Consent.organization
Definition

The organization that manages the consent, and the framework within which it is executed.

Control0..*
TypeReference(ehealth-organization)
Alternate Namescustodian
33. Consent.source[x]
Definition

The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document.

Control0..1
TypeChoice of: Attachment, Identifier, Reference(ehealth-consent | ehealth-documentreference | Contract | ehealth-questionnaireresponse)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

34. Consent.policy
Definition

The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
35. Consent.policy.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
36. Consent.policy.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

37. Consent.policy.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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

38. Consent.policy.authority
Definition

Entity or Organization having regulatory jurisdiction or accountability for  enforcing policies pertaining to Consent Directives.

Control0..1 This element is affected by the following invariants: ppc-1
Typeuri
39. Consent.policy.uri
Definition

The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

Control0..1 This element is affected by the following invariants: ppc-1
Typeuri
Comments

This element is for discoverability / documentation, and does not modify or qualify the policy rules.

40. Consent.policyRule
Definition

A referece to the specific computable policy.

Control0..1 This element is affected by the following invariants: ppc-1
Typeuri
Requirements

Might be a unique identifier of a policy set in XACML, or other rules engine.

Comments

If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.

41. Consent.securityLabel
Definition

A set of security labels that define which resources are controlled by this consent. If more than one label is specified, all resources must have all the specified labels.

Control0..*
BindingSecurity Labels from the Healthcare Privacy and Security Classification System.
The codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable
TypeCoding
Comments

If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?).

42. Consent.purpose
Definition

The context of the activities a user is taking - why the user is accessing the data - that are controlled by this consent.

Control0..*
BindingWhat purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
The codes SHALL be taken from PurposeOfUse; other codes may be used where these codes are not suitable
TypeCoding
Comments

This element is for discoverability / documentation, and does not modify or qualify the policy (e.g. the policy itself describes the purposes for which it applies).

43. Consent.dataPeriod
Definition

Clinical or Operational Relevant period of time that bounds the data controlled by this consent.

Control0..1
TypePeriod
Comments

This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

44. Consent.data
Definition

The resources controlled by this consent, if specific resources are referenced.

The infrastructure will enforce consent rules based on the EpisodeOfCare.

Control1..*
TypeBackboneElement
Meaning if Missingall data
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
45. Consent.data.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
46. Consent.data.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

47. Consent.data.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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

48. Consent.data.meaning
Definition

How the resource reference is interpreted when testing consent restrictions.

Control1..1
BindingHow a resource reference is interpreted when testing consent restrictions
The codes SHALL be taken from ConsentDataMeaning
Typecode
49. Consent.data.reference
Definition

A reference to a specific resource that defines which resources are covered by this consent.

Control1..1
TypeReference(ehealth-episodeofcare)
50. Consent.except
Definition

An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
51. Consent.except.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
52. Consent.except.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

53. Consent.except.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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

54. Consent.except.type
Definition

Action to take - permit or deny - when the exception conditions are met.

Control1..1
BindingHow an exception statement is applied, such as adding additional consent or removing consent
The codes SHALL be taken from ConsentExceptType
Typecode
55. Consent.except.period
Definition

The timeframe in this exception is valid.

Control0..1
TypePeriod
56. Consent.except.actor
Definition

Who or what is controlled by this Exception. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

Control0..*
TypeBackboneElement
Meaning if MissingThere is no specific actor associated with the exception
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
57. Consent.except.actor.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
58. Consent.except.actor.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

59. Consent.except.actor.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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

60. Consent.except.actor.role
Definition

How the individual is involved in the resources content that is described in the exception.

Control1..1
BindingHow an actor is involved in the consent considerations
The codes SHALL be taken from SecurityRoleType; other codes may be used where these codes are not suitable
TypeCodeableConcept
61. Consent.except.actor.reference
Definition

The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').

Control1..1
TypeReference(ehealth-device | Group | ehealth-careteam | ehealth-organization | ehealth-patient | ehealth-practitioner | ehealth-relatedperson)
62. Consent.except.action
Definition

Actions controlled by this Exception.

Control0..*
BindingDetailed codes for the consent action.
For example codes, see Consent Action Codes
TypeCodeableConcept
Comments

Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.

Meaning if Missingall actions
63. Consent.except.securityLabel
Definition

A set of security labels that define which resources are controlled by this exception. If more than one label is specified, all resources must have all the specified labels.

Control0..*
BindingSecurity Labels from the Healthcare Privacy and Security Classification System.
The codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable
TypeCoding
Comments

If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?).

64. Consent.except.purpose
Definition

The context of the activities a user is taking - why the user is accessing the data - that are controlled by this exception.

Control0..*
BindingWhat purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
The codes SHALL be taken from PurposeOfUse; other codes may be used where these codes are not suitable
TypeCoding
Comments

E.g. if the purpose is 'research', then the operational context must be research, in order for the consent to apply. Not all of the security labels make sense for use in this element (may define a narrower value set?).

65. Consent.except.class
Definition

The class of information covered by this exception. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.

Control0..*
BindingThe class (type) of information a consent rule covers
The codes SHALL be taken from Consent Content Class; other codes may be used where these codes are not suitable
TypeCoding
Comments

Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.

66. Consent.except.code
Definition

If this code is found in an instance, then the exception applies.

Control0..*
BindingIf this code is found in an instance, then the exception applies
For example codes, see Consent Content Codes
TypeCoding
Comments

Typical use of this is a Document code with class = CDA.

67. Consent.except.dataPeriod
Definition

Clinical or Operational Relevant period of time that bounds the data controlled by this exception.

Control0..1
TypePeriod
Comments

This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

68. Consent.except.data
Definition

The resources controlled by this exception, if specific resources are referenced.

Control0..*
TypeBackboneElement
Meaning if Missingall data
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
69. Consent.except.data.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
70. Consent.except.data.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. 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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

71. Consent.except.data.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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

72. Consent.except.data.meaning
Definition

How the resource reference is interpreted when testing consent restrictions.

Control1..1
BindingHow a resource reference is interpreted when testing consent restrictions
The codes SHALL be taken from ConsentDataMeaning
Typecode
73. Consent.except.data.reference
Definition

A reference to a specific resource that defines which resources are covered by this consent.

Control1..1
TypeReference(Resource)