eHealth Infrastructure (v2020.4)

StructureDefinition: ehealth-communication - Detailed Descriptions

Definitions for the ehealth-communication Profile.

1. Communication
Definition

An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency was notified about a reportable condition.

Control0..*
InvariantsDefined on this element
com-1: Not Done Reason can only be specified if NotDone is "true" (: notDone or notDoneReason.exists().not())
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())
2. Communication.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. Communication.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. Communication.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. Communication.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. Communication.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. Communication.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. Communication.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices on Communication.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. Communication.extension:recipientCareTeam
SliceNamerecipientCareTeam
Definition

CareTeam message recipient

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(recipientCareTeam) (Extension Type: Reference)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Communication.extension:senderCareTeam
SliceNamesenderCareTeam
Definition

CareTeam message sender

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(senderCareTeam) (Extension Type: Reference)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. Communication.extension:restrictionCategory
SliceNamerestrictionCategory
Definition

Restriction category

Control1..* This element is affected by the following invariants: ele-1
TypeExtension(restriction-category) (Extension Type: CodeableConcept)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
12. Communication.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.

13. Communication.identifier
Definition

Identifiers associated with this Communication that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
14. Communication.definition
Definition

A protocol, guideline, or other definition that was adhered to in whole or in part by this communication event.

Control0..*
TypeReference(ehealth-plandefinition | ehealth-activitydefinition)
15. Communication.basedOn
Definition

An order, proposal or plan fulfilled in whole or in part by this Communication.

Control0..*
TypeReference(Resource)
Alternate Namesfulfills
Comments

This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ReferralRequest, MedicationRequest, etc.

16. Communication.partOf
Definition

Part of this action.

Control0..*
TypeReference(Resource)
Alternate Namescontainer
17. Communication.status
Definition

The status of the transmission.

Control1..1
BindingThe status of the communication.
The codes SHALL be taken from EventStatus
Typecode
Is Modifiertrue
Comments

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

18. Communication.notDone
Definition

If true, indicates that the described communication event did not actually occur.

Control0..1
Typeboolean
Is Modifiertrue
Requirements

Creating a Communication where notDone is true is intended for situations where there's a need for a specific statement in the record about something not being done. If the need is merely to indicate that a request wasn't fulfilled, that should be handled using Task.

Comments

This element is labeled as a modifier because it marks the communication as a communication that did not occur. The more attributes are populated, the more constrained the negated statement is.

19. Communication.notDoneReason
Definition

Describes why the communication event did not occur in coded and/or textual form.

Control0..1 This element is affected by the following invariants: com-1
BindingCodes for the reason why a communication was not done.
For example codes, see CommunicationNotDoneReason
TypeCodeableConcept
20. Communication.category
Definition

The type of message conveyed such as alert, notification, reminder, instruction, etc.

Control1..*
BindingThe codes SHALL be taken from Communication Category
TypeCodeableConcept
Comments

There may be multiple axes of categorization and one communication may serve multiple purposes.

21. Communication.medium
Definition

A channel that was used for this communication (e.g. email, fax).

Control0..*
BindingCodes for communication mediums such as phone, fax, email, in person, etc.
For example codes, see ParticipationMode
TypeCodeableConcept
22. Communication.subject
Definition

Patient for which data is the topic of this communication.

Control1..1
TypeReference(ehealth-patient)
Alternate Namespatient
23. Communication.recipient
Definition

Restrictions on who are allowed to read this particular message within the set of actors involved in the episode (identified in context). Setting no reference means no restrictions, while only referencing same entity as identified in sender corresponds to a private message.

Control0..*
TypeReference(ehealth-device | ehealth-patient | ehealth-practitioner | ehealth-relatedperson | Group)
24. Communication.topic
Definition

The resources which were responsible for or related to producing this communication.

Control1..*
TypeReference(Resource)
25. Communication.context
Definition

Episode in which context the message occurs.

Control1..1
TypeReference(Encounter | ehealth-episodeofcare)
Alternate Namesencounter
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Episode in which context the message occurs.

26. Communication.sent
Definition

The time when this communication was sent.

Control0..1
TypedateTime
27. Communication.received
Definition

The time when this communication arrived at the destination.

Control0..1
TypedateTime
28. Communication.sender
Definition

Who created the message.

Control0..1
TypeReference(ehealth-device | ehealth-patient | ehealth-practitioner | ehealth-relatedperson)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Who created the message.

29. Communication.reasonCode
Definition

The reason or justification for the communication.

Control0..*
BindingCodes for describing reasons for the occurrence of a communication.
For example codes, see SNOMED CT Clinical Findings
TypeCodeableConcept
Comments

Textual reasons can be caprued using reasonCode.text.

30. Communication.reasonReference
Definition

Indicates another resource whose existence justifies this communication.

Control0..*
TypeReference(ehealth-condition | ehealth-observation)
31. Communication.payload
Definition

Text, attachment(s), or resource(s) that was communicated to the recipient.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
32. Communication.payload.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
33. Communication.payload.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.

34. Communication.payload.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.

35. Communication.payload.content[x]
Definition

A communicated content (or for multi-part communications, one portion of the communication).

Control1..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
SlicingThis element introduces a set of slices on Communication.payload.content[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
36. Communication.payload.content[x]:contentString
SliceNamecontentString
Definition

A communicated content (or for multi-part communications, one portion of the communication).

Control1..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
37. Communication.note
Definition

Additional notes or commentary about the communication by the sender, receiver or other interested parties.

Control0..*
TypeAnnotation