DSTU2 QA Preview

This page is part of the FHIR Specification (v1.0.0: DSTU 2 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

A.??.4 StructureDefinition: USLab-PHPract - Detailed Descriptions

Definitions for the uslab-phpract Profile.

Practitioner(USLab-PHPract)
Definition

This is the provider who either ordered a lab test or to whom the results have been sent.

Control0..*
TypePractitioner
Alternate NamesProvider, Orderer, Submitting Physician
Comments

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

InvariantsDefined on this element
inv-1: Shall have Organization.name and/or Organization.identifier. (xpath: exists(f:name) or exists(f:identifier))
Practitioner.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. Bundles always have an id, though it is usually a generated UUID.

Practitioner.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
Practitioner.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 as much as possible.

Practitioner.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
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).

Practitioner.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.

Practitioner.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.

Practitioner.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.

Practitioner.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.

Practitioner.identifier
Definition

An identifier that applies to this person in this role.

Control0..1
TypeIdentifier
Must Supporttrue
Requirements

Either id or name is needed.

Comments

The identifier shall be a provider NPI.

Practitioner.identifier.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Practitioner.identifier.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.

Practitioner.identifier.use
Definition

The purpose of this identifier.

Control1..1
BindingIdentifies the purpose for this identifier, if known
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

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

Practitioner.identifier.type
Definition

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

Control0..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.

Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Practitioner.identifier.system
Definition

See https://nppes.cms.hhs.gov/NPPES/.

Control1..1
Typeuri
Must Supporttrue
Requirements

NPI for practitioner is used.

Fixed Valueurn:oid:2.16.840.1.113883.4.6
Examplehttp://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Practitioner.identifier.value
Definition

NPI Provider Number.

Control1..1
Typestring
Must Supporttrue
Comments

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

Example123456
Practitioner.identifier.period
Definition

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

Control0..1
TypePeriod
Practitioner.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Comments

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

Practitioner.active
Definition

Whether this practitioner's record is in active use.

Control0..1
Typeboolean
Requirements

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

Comments

Default is true.

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

Default Valuetrue
Practitioner.name
Definition

A name associated with the person.

Control0..1
TypeHumanName
Must Supporttrue
Requirements

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

Practitioner.name.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Practitioner.name.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.

Practitioner.name.use
Definition

Identifies the purpose for this name.

Control0..1
BindingThe use of a human name
The codes SHALL be taken from NameUse
Typecode
Is Modifiertrue
Requirements

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

Comments

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

Practitioner.name.text
Definition

A full text representation of the name.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and structured parts.

Practitioner.name.family
Definition

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

Control1..1
Typestring
Must Supporttrue
Alternate Namessurname
Comments

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

Practitioner.name.given
Definition

Given name.

Control0..2
Typestring
Must Supporttrue
Alternate Namesfirst name, middle name
Comments

Can be first and middle name or initial.

Practitioner.name.prefix
Definition

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

Control0..1
Typestring
Must Supporttrue
Practitioner.name.suffix
Definition

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

Control0..1
Typestring
Must Supporttrue
Practitioner.name.period
Definition

Indicates the period of time when this name was valid for the named person.

Control0..1
TypePeriod
Requirements

Allows names to be placed in historical context.

Practitioner.telecom
Definition

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

Control0..2
TypeContactPoint
Must Supporttrue
Requirements

Need to know how to reach a practitioner.

Comments

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

Practitioner.telecom.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Practitioner.telecom.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.

Practitioner.telecom.system
Definition

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

Control1..1 This element is affected by the following invariants: cpt-2
BindingTelecommunications form for contact point
The codes SHALL be taken from ContactPointSystem
Typecode
Must Supporttrue
Practitioner.telecom.value
Definition

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

Control1..1
Typestring
Must Supporttrue
Requirements

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

Comments

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

Practitioner.telecom.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingUse of contact point
The codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Requirements

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

Comments

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

Practitioner.telecom.rank
Definition

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

Control0..1
TypepositiveInt
Comments

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

Practitioner.telecom.period
Definition

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

Control0..1
TypePeriod
Practitioner.address
Definition

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

Control0..1
TypeAddress
Must Supporttrue
Requirements

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

Practitioner.address.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Practitioner.address.extension (http://hl7.org/fhir/StructureDefinition/us-core-county)
Definition

Name of county.

Control0..1
TypeExtension (Extension Type: string)
Practitioner.address.use
Definition

The purpose of this address.

Control0..1
BindingThe use of an address
The codes SHALL be taken from AddressUse
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

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

Comments

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

Examplehome
Practitioner.address.type
Definition

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

Control0..1
BindingThe type of an address (physical / postal)
The codes SHALL be taken from AddressType
Typecode
Exampleboth
Practitioner.address.text
Definition

A full text representation of the address.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts.

Example137 Nowhere Street, Erewhon 9132
Practitioner.address.line
Definition

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

Control0..2
Typestring
Must Supporttrue
Requirements

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

Example137 Nowhere Street
Practitioner.address.city
Definition

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

Control0..1
Typestring
Must Supporttrue
Alternate NamesMuncipality
ExampleErewhon
Practitioner.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
Alternate NamesCounty
Comments

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

ExampleMadison
Practitioner.address.state
Definition

Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (i.e. US 2 letter state codes).

Control0..1
BindingTwo letter USPS alphabetic codes.
The codes SHALL be taken from USPS Two Letter Alphabetic Codes
Typestring
Must Supporttrue
Requirements

State SHALL be the two letter USPS alphabetic codes.

Alternate NamesProvince, Territory
Practitioner.address.postalCode
Definition

US Zip Codes.

Control0..1
Typestring
Must Supporttrue
Requirements

Zip or Postal Code SHALL be formatted as 99999[-9999] for US Zip or ZIP +4 codes.

Alternate NamesZip
Example9132
InvariantsDefined on this element
inv-2: (Zip or Postal Code) SHALL be formatted as 99999[-9999] for US Zip or ZIP +4 codes or as A9A9A9 for Canadian postal codes. (xpath: f:matches(issued,[0-9]{5}(-[0-9]{4}){0,1} ))
Practitioner.address.country
Definition

ISO 3166 3 letter Country Code.

Control0..1
BindingISO 2 letter Country Codes
The codes SHALL be taken from http://www.iso.org/iso/country_codes.htm
Typestring
Must Supporttrue
Requirements

Country SHALL be ISO 3166 3 letter codes.

Comments

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

Practitioner.address.period
Definition

Time period when address was/is in use.

Control0..1
TypePeriod
Requirements

Allows addresses to be placed in historical context.

Example&lt;valuePeriod&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;start&nbsp;value=&quot;2010-03-23&quot;/&gt;<br/>&nbsp;&nbsp;&lt;end&nbsp;value=&quot;2010-07-01&quot;/&gt;<br/>&lt;/valuePeriod&gt;<br/>
Practitioner.gender
Definition

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

Control0..1
BindingThe gender of a person used for administrative purposes
The codes SHALL be taken from AdministrativeGender
Typecode
Requirements

Needed to address the person correctly.

Practitioner.birthDate
Definition

The date of birth for the practitioner.

Control0..1
Typedate
Requirements

Needed for identification.

Practitioner.photo
Definition

Image of the person.

Control0..*
TypeAttachment
Requirements

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

Practitioner.practitionerRole
Definition

The list of Roles/Organizations that the Practitioner is associated with.

Control1..1
TypeBackboneElement
Must Supporttrue
Practitioner.practitionerRole.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Practitioner.practitionerRole.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.

Practitioner.practitionerRole.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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.

Practitioner.practitionerRole.managingOrganization
Definition

A reference to the organization that placed the lab order. It could be a doctor's office, hospital or clinic.

Control1..1
TypeReference(US Laboratory Organization Profile)
Must Supporttrue
Practitioner.practitionerRole.role
Definition

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

Control0..1
BindingThe role a person plays representing an organization
For example codes, see PractitionerRole
TypeCodeableConcept
Requirements

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

Comments

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

Practitioner.practitionerRole.specialty
Definition

Specific specialty of the practitioner.

Control0..*
BindingSpecific specialty associated with the agency
For example codes, see PractitionerSpecialty
TypeCodeableConcept
Practitioner.practitionerRole.period
Definition

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

Control0..1
TypePeriod
Requirements

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

Practitioner.practitionerRole.location
Definition

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

Control0..*
TypeReference(Location)
Practitioner.practitionerRole.healthcareService
Definition

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

Control0..*
TypeReference(HealthcareService)
Practitioner.qualification
Definition

Qualifications obtained by training and certification.

Control0..*
TypeBackboneElement
Practitioner.qualification.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Practitioner.qualification.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.

Practitioner.qualification.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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.

Practitioner.qualification.identifier
Definition

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

Control0..*
TypeIdentifier
Requirements

Often, specific identities are assigned for the qualification.

Practitioner.qualification.code
Definition

Coded representation of the qualification.

Control1..1
BindingSpecific qualification the practitioner has to provide a service
For example codes, see ANZSCO -- Australian and New Zealand Standard Classification of Occupations, 2013, Version 1.2
TypeCodeableConcept
Practitioner.qualification.period
Definition

Period during which the qualification is valid.

Control0..1
TypePeriod
Requirements

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

Practitioner.qualification.issuer
Definition

Organization that regulates and issues the qualification.

Control0..1
TypeReference(Organization)
Practitioner.communication
Definition

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

Control0..*
BindingA human language
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
TypeCodeableConcept
Requirements

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

Comments

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