2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

5.19 Resource Communication - Content

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.

5.19.1 Scope and Usage

These resources have not yet undergone proper review by PC, CQI, CDS, and OO. At this time, they are to be considered only as draft resource proposals for potential submission.

This resource is a record of a request for a communication to be performed. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The sender and receivers may be patients, practitioners, related persons, organizations, and devices. Uses of communication request include

  • A computer-based decision-support system requesting a reminder or alert be delivered to a responsible provider
  • A physician requesting notification from the nurse if a patient's temperature exceeds a value
  • A monitoring system or a provider requesting a staff member or department to notify a public health agency of a patient presenting with a reportable communicable disease public health agency
    • As indicated above the request, may represent an order that entered by a practitioner in a CPOE system as well as a proposal made by a clinical decision support system (CDSS) based on a patient's clinical record and context of care.

    5.19.2 Boundaries and Relationships

    This resource is a record of a request. It does not represent the actual flow of communication. The use of CommunicationRequest. excludes requests for referrals which are covered by the ReferralRequest resource. The resource also excludes the types of communications supported by the Alert resource (need to better describe this overlap). Communication of orders and the ensuing responses are described by Order and OrderResponse resources.

    5.19.3 Resource Content

    Structure

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Communication DomainResourceCommunication
    ... identifier 0..*IdentifierUnique identifier
    ... category 0..1CodeableConceptMessage category
    ... sender 0..1Patient | Practitioner | Device | RelatedPerson | OrganizationMessage sender
    ... recipient 0..*Patient | Device | RelatedPerson | PractitionerMessage recipient
    ... payload 0..*ElementMessage payload
    .... content[x] Message part content
    ..... contentString1..1string
    ..... contentAttachment1..1Attachment
    ..... contentReference1..1Any
    ... medium 0..*CodeableConceptCommunication medium
    ... status M0..1codein-progress | completed | suspended | rejected | failed
    CommunicationStatus (Required)
    ... encounter 0..1EncounterEncounter leading to message
    ... sent 0..1dateTimeWhen sent
    ... received 0..1dateTimeWhen received
    ... reason 0..*CodeableConceptIndication for message
    ... subject 0..1PatientFocus of message

    UML Diagram

    Communication (DomainResource)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)identifier : Identifier 0..*The type of message such as alert, notification, reminder, instruction, etccategory : CodeableConcept 0..1The entity (e.g., person, organization, clinical information system, or device) which is the source of the communicationsender : Reference(Patient|Practitioner|Device| RelatedPerson|Organization) 0..1The entity (e.g., person, organization, clinical information system, or device) which is the target of the communicationrecipient : Reference(Patient|Device|RelatedPerson| Practitioner) 0..*The communication medium, e.g., email, faxmedium : CodeableConcept 0..*The status of the transmission (this element modifies the meaning of other elements)status : code 0..1 « The status of the communicationCommunicationStatus »The encounter within which the communication was sentencounter : Reference(Encounter) 0..1The time when this communication was sentsent : dateTime 0..1The time when this communication arrived at the destinationreceived : dateTime 0..1The reason or justification for the communicationreason : CodeableConcept 0..*The patient who is the focus of this communicationsubject : Reference(Patient) 0..1PayloadAn individual message part for multi-part messagescontent[x] : string|Attachment|Reference(Any) 1..1Text, attachment(s), or resource(s) to be communicated to the recipientpayload0..*

    XML Template

    <Communication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier --></identifier>
 <category><!-- 0..1 CodeableConcept Message category --></category>
 <sender><!-- 0..1 Reference(Patient|Practitioner|Device|RelatedPerson|
   Organization) Message sender --></sender>
 <recipient><!-- 0..* Reference(Patient|Device|RelatedPerson|Practitioner) 
     Message recipient --></recipient>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <medium><!-- 0..* CodeableConcept Communication medium --></medium>
 <status value="[code]"/><!-- 0..1 in-progress | completed | suspended | rejected | failed -->
 <encounter><!-- 0..1 Reference(Encounter) Encounter leading to message --></encounter>
 <sent value="[dateTime]"/><!-- 0..1 When sent -->
 <received value="[dateTime]"/><!-- 0..1 When received -->
 <reason><!-- 0..* CodeableConcept Indication for message --></reason>
 <subject><!-- 0..1 Reference(Patient) Focus of message --></subject>
</Communication>

    JSON Template

    {doco
  "resourceType" : "Communication",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier
  "category" : { CodeableConcept }, // Message category
  "sender" : { Reference(Patient|Practitioner|Device|RelatedPerson|
   Organization) }, // Message sender
  "recipient" : [{ Reference(Patient|Device|RelatedPerson|Practitioner) }], // 
     Message recipient
  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }
  }],
  "medium" : [{ CodeableConcept }], // Communication medium
  "status" : "<code>", // in-progress | completed | suspended | rejected | failed
  "encounter" : { Reference(Encounter) }, // Encounter leading to message
  "sent" : "<dateTime>", // When sent
  "received" : "<dateTime>", // When received
  "reason" : [{ CodeableConcept }], // Indication for message
  "subject" : { Reference(Patient) } // Focus of message
}

    Structure

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Communication DomainResourceCommunication
    ... identifier 0..*IdentifierUnique identifier
    ... category 0..1CodeableConceptMessage category
    ... sender 0..1Patient | Practitioner | Device | RelatedPerson | OrganizationMessage sender
    ... recipient 0..*Patient | Device | RelatedPerson | PractitionerMessage recipient
    ... payload 0..*ElementMessage payload
    .... content[x] Message part content
    ..... contentString1..1string
    ..... contentAttachment1..1Attachment
    ..... contentReference1..1Any
    ... medium 0..*CodeableConceptCommunication medium
    ... status M0..1codein-progress | completed | suspended | rejected | failed
    CommunicationStatus (Required)
    ... encounter 0..1EncounterEncounter leading to message
    ... sent 0..1dateTimeWhen sent
    ... received 0..1dateTimeWhen received
    ... reason 0..*CodeableConceptIndication for message
    ... subject 0..1PatientFocus of message

    UML Diagram

    Communication (DomainResource)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)identifier : Identifier 0..*The type of message such as alert, notification, reminder, instruction, etccategory : CodeableConcept 0..1The entity (e.g., person, organization, clinical information system, or device) which is the source of the communicationsender : Reference(Patient|Practitioner|Device| RelatedPerson|Organization) 0..1The entity (e.g., person, organization, clinical information system, or device) which is the target of the communicationrecipient : Reference(Patient|Device|RelatedPerson| Practitioner) 0..*The communication medium, e.g., email, faxmedium : CodeableConcept 0..*The status of the transmission (this element modifies the meaning of other elements)status : code 0..1 « The status of the communicationCommunicationStatus »The encounter within which the communication was sentencounter : Reference(Encounter) 0..1The time when this communication was sentsent : dateTime 0..1The time when this communication arrived at the destinationreceived : dateTime 0..1The reason or justification for the communicationreason : CodeableConcept 0..*The patient who is the focus of this communicationsubject : Reference(Patient) 0..1PayloadAn individual message part for multi-part messagescontent[x] : string|Attachment|Reference(Any) 1..1Text, attachment(s), or resource(s) to be communicated to the recipientpayload0..*

    XML Template

    <Communication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier --></identifier>
 <category><!-- 0..1 CodeableConcept Message category --></category>
 <sender><!-- 0..1 Reference(Patient|Practitioner|Device|RelatedPerson|
   Organization) Message sender --></sender>
 <recipient><!-- 0..* Reference(Patient|Device|RelatedPerson|Practitioner) 
     Message recipient --></recipient>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <medium><!-- 0..* CodeableConcept Communication medium --></medium>
 <status value="[code]"/><!-- 0..1 in-progress | completed | suspended | rejected | failed -->
 <encounter><!-- 0..1 Reference(Encounter) Encounter leading to message --></encounter>
 <sent value="[dateTime]"/><!-- 0..1 When sent -->
 <received value="[dateTime]"/><!-- 0..1 When received -->
 <reason><!-- 0..* CodeableConcept Indication for message --></reason>
 <subject><!-- 0..1 Reference(Patient) Focus of message --></subject>
</Communication>

    JSON Template

    {doco
  "resourceType" : "Communication",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier
  "category" : { CodeableConcept }, // Message category
  "sender" : { Reference(Patient|Practitioner|Device|RelatedPerson|
   Organization) }, // Message sender
  "recipient" : [{ Reference(Patient|Device|RelatedPerson|Practitioner) }], // 
     Message recipient
  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }
  }],
  "medium" : [{ CodeableConcept }], // Communication medium
  "status" : "<code>", // in-progress | completed | suspended | rejected | failed
  "encounter" : { Reference(Encounter) }, // Encounter leading to message
  "sent" : "<dateTime>", // When sent
  "received" : "<dateTime>", // When received
  "reason" : [{ CodeableConcept }], // Indication for message
  "subject" : { Reference(Patient) } // Focus of message
}

     

    Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire

    5.19.3.1 Terminology Bindings

    PathDefinitionTypeReference
    Communication.status The status of the communicationFixedhttp://hl7.org/fhir/communication-status

    Notes to reviewers:

    At this time, the code bindings are placeholders to be fleshed out upon further review by the community.

    5.19.4 Search Parameters

    Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

    NameTypeDescriptionPaths
    categorytokenMessage categoryCommunication.category
    encounterreferenceEncounter leading to messageCommunication.encounter
    (Encounter)
    identifiertokenUnique identifierCommunication.identifier
    mediumtokenCommunication mediumCommunication.medium
    patientreferenceFocus of messageCommunication.subject
    (Patient)
    receiveddateWhen receivedCommunication.received
    recipientreferenceMessage recipientCommunication.recipient
    (Device, Patient, Practitioner, RelatedPerson)
    senderreferenceMessage senderCommunication.sender
    (Device, Organization, Patient, Practitioner, RelatedPerson)
    sentdateWhen sentCommunication.sent
    statustokenin-progress | completed | suspended | rejected | failedCommunication.status
    subjectreferenceFocus of messageCommunication.subject
    (Patient)