eHealth Infrastructure (v2020.8)

StructureDefinition: ehealth-message - Detailed Descriptions

Definitions for the ehealth-message 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())
message-invariant: Category message invariant (: category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not() or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/') or sender.reference.contains('Device/'))) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() ))
nemsms-1: If communication resource is a NemSMS payload cannot exceed 160 (: medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160)
note-invariant: Category note invariant (: category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()))
notification-invariant: Category notification invariant (: category.coding.code = 'notification' implies recipient.reference.contains('Patient/') and ( sender.reference.contains('Practitioner/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists()))
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
BindingThe codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Max Binding: All Languages A human language.

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..1 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..1 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

Optional Extension Element - found in all resources

Control0..* 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.extension:restrictionCategory.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
13. Communication.extension:restrictionCategory.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 Communication.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
14. Communication.extension:restrictionCategory.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category
15. Communication.extension:restrictionCategory.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control1..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
SlicingThis element introduces a set of slices on Communication.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
16. Communication.extension:restrictionCategory.value[x]:valueCodeableConcept
SliceNamevalueCodeableConcept
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)..

Control1..1
BindingThe codes SHALL be taken from Restriction Category
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
17. Communication.extension:restrictionCategory.value[x]:valueCodeableConcept.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
18. Communication.extension:restrictionCategory.value[x]:valueCodeableConcept.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 Communication.extension.value[x].extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
19. Communication.extension:restrictionCategory.value[x]:valueCodeableConcept.coding
Definition

A reference to a code defined by a terminology system..

Control0..*
BindingThe codes SHALL be taken from Restriction Category
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.

20. Communication.extension:restrictionCategory.value[x]:valueCodeableConcept.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.

21. Communication.extension:threadId
SliceNamethreadId
Definition

An Extension

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(MeetingURL) (Extension Type: string)
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())
22. Communication.extension:threadId.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
23. Communication.extension:threadId.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 Communication.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
24. Communication.extension:threadId.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
25. Communication.extension:threadId.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..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.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
26. Communication.extension:threadId.value[x]:valueString
SliceNamevalueString
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
27. Communication.extension:period
SliceNameperiod
Definition

An Extension

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(Period) (Extension Type: Period)
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())
28. Communication.extension:administrativeStatus
SliceNameadministrativeStatus
Definition

An Extension

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(AdministrativeStatus) (Extension Type: Coding)
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())
29. Communication.extension:title
SliceNametitle
Definition

Message title

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(Title) (Extension Type: string)
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())
30. Communication.extension:priority
SliceNamepriority
Definition

An Extension

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(MeetingURL) (Extension Type: code)
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())
31. Communication.extension:priority.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
32. Communication.extension:priority.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 Communication.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
33. Communication.extension:priority.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority
34. Communication.extension:priority.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
SlicingThis element introduces a set of slices on Communication.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • type @ $this
35. Communication.extension:priority.value[x]:valueCode
SliceNamevalueCode
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..1
BindingThe codes SHALL be taken from Priority
Typecode
[x] NoteSee Choice of Data Types for further information about how to use [x]
36. Communication.extension:groupId
SliceNamegroupId
Definition

An Extension

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(ehealth-group-id) (Extension Type: string)
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())
37. Communication.extension:onBehalfOf
SliceNameonBehalfOf
Definition

An Extension

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(ehealth-on-behalf-of) (Extension Type: Reference)
Must Supporttrue
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())
38. 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.

39. 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
40. Communication.definition
Definition

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

Control0..*
TypeReference(PlanDefinition | ActivityDefinition)
41. 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.

42. Communication.partOf
Definition

The CarePlan that this communication relates to (when relevant)

Control0..*
TypeReference(CarePlan)
Alternate Namescontainer
43. Communication.status
Definition

The status of the transmission

Control1..1
BindingThe 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.

44. 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.

45. Communication.notDoneReason
Definition

Describes why the communication event has not occured in coded and/or textual form.

Control0..1 This element is affected by the following invariants: com-1
BindingThe codes SHALL be taken from CommunicationNotDoneReason Codes for the reason why a communication has not occured.

TypeCodeableConcept
Must Supporttrue
46. Communication.category
Definition

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

Control1..*
BindingFor example codes, see CommunicationCategory Codes for general categories of communications such as alerts, instruction, etc.

TypeCodeableConcept
Comments

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

SlicingThis element introduces a set of slices on Communication.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ coding.system
47. Communication.category:DkTmCategory
SliceNameDkTmCategory
Definition

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

Control1..1
BindingFor example codes, see CommunicationCategory Codes for general categories of communications such as alerts, instruction, etc.

TypeCodeableConcept
Comments

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

48. Communication.category:DkTmCategory.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
49. Communication.category:DkTmCategory.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 Communication.category.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
50. Communication.category:DkTmCategory.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
BindingThe codes SHALL be taken from MessageCategory
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.

51. Communication.category:DkTmCategory.coding.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. Communication.category:DkTmCategory.coding.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 Communication.category.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
53. Communication.category:DkTmCategory.coding.system
Definition

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

Control1..1
Typeuri
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 Valuehttp://ehealth.sundhed.dk/cs/message-category
54. Communication.category:DkTmCategory.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.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
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.

55. Communication.category:DkTmCategory.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).

Control0..1
BindingThe codes SHALL be taken from MessageCategory
Typecode
Requirements

Need to refer to a particular code in the system.

56. Communication.category:DkTmCategory.coding.display
Definition

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

Control0..1
Typestring
Requirements

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

57. Communication.category:DkTmCategory.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).

Control0..1
Typeboolean
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.

58. Communication.category:DkTmCategory.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.

59. Communication.medium
Definition

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

Control0..*
BindingFor example codes, see ParticipationMode Codes for communication mediums such as phone, fax, email, in person, etc.

TypeCodeableConcept
SlicingThis element introduces a set of slices on Communication.medium. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ coding.system
60. Communication.medium:DkTmMedium
SliceNameDkTmMedium
Definition

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

Control0..1
BindingFor example codes, see MessageMedium Codes for communication mediums

TypeCodeableConcept
61. Communication.medium:DkTmMedium.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
62. Communication.medium:DkTmMedium.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 Communication.medium.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
63. Communication.medium:DkTmMedium.coding
Definition

A reference to a code defined by a terminology system

Control0..*
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.

64. Communication.medium:DkTmMedium.coding.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
65. Communication.medium:DkTmMedium.coding.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 Communication.medium.coding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
66. Communication.medium:DkTmMedium.coding.system
Definition

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

Control1..1
Typeuri
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 Valuehttp://ehealth.sundhed.dk/cs/message-medium
67. Communication.medium:DkTmMedium.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.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
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.

68. Communication.medium:DkTmMedium.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).

Control0..1
BindingThe codes SHALL be taken from MessageMedium A valid message medium must be supplied

Typecode
Requirements

Need to refer to a particular code in the system.

69. Communication.medium:DkTmMedium.coding.display
Definition

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

Control0..1
Typestring
Requirements

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

70. Communication.medium:DkTmMedium.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).

Control0..1
Typeboolean
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.

71. Communication.medium:DkTmMedium.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.

72. Communication.subject
Definition

The patient or group that was the focus of this communication.

Control0..1
TypeReference(Patient | Group)
Alternate Namespatient
73. Communication.recipient
Definition

The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient.  Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time).

Control0..1
TypeReference(Patient | Practitioner)
74. Communication.topic
Definition

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

Control0..*
TypeReference(Resource)
75. Communication.context
Definition

The encounter within which the communication was sent.

Control0..1
TypeReference(Encounter | EpisodeOfCare)
Alternate Namesencounter
76. Communication.sent
Definition

The time when this communication was sent.

Control0..1
TypedateTime
77. Communication.received
Definition

The time when this communication arrived at the destination.

Control0..1
TypedateTime
78. Communication.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

Control0..1
TypeReference(Device | Patient | Practitioner)
79. Communication.reasonCode
Definition

The reason or justification for the communication.

Control0..*
BindingFor example codes, see SNOMED CT Clinical Findings Codes for describing reasons for the occurrence of a communication.

TypeCodeableConcept
Comments

Textual reasons can be caprued using reasonCode.text.

80. Communication.reasonCode.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
81. Communication.reasonCode.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 Communication.reasonCode.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
82. Communication.reasonCode.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
BindingThe codes SHALL be taken from eHealth Message Reason Code
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.

83. Communication.reasonCode.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.

84. Communication.reasonReference
Definition

Indicates another resource whose existence justifies this communication.

Control0..*
TypeReference(Condition | Observation)
85. Communication.payload
Definition

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

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
86. 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
87. 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.

88. 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.

89. 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
90. 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]
91. Communication.note
Definition

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

Control0..*
TypeAnnotation
92. Communication.note.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
93. Communication.note.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 Communication.note.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
94. Communication.note.author[x]
Definition

The individual responsible for making the annotation.

Control0..1
TypeChoice of: Reference(Practitioner | Patient | RelatedPerson), string
[x] NoteSee Choice of Data Types for further information about how to use [x]
95. Communication.note.time
Definition

Indicates when this particular annotation was made.

Control0..1
TypedateTime
96. Communication.note.text
Definition

The text of the annotation.

Control1..1
Typestring