R5 Final QA

This page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - see ballot notes). 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

Patient Care icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the Communication resource.

Communication
Element IdCommunication
Definition

A clinical or business level record of information being transmitted or shared; e.g. an alert that was sent to a responsible provider, a public health agency communication to a provider/reporter in response to a case report for a reportable condition.

Short DisplayA clinical or business level record of information being transmitted or shared
Cardinality0..*
TypeDomainResource
Summaryfalse
Communication.identifier
Element IdCommunication.identifier
Definition

Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

Short DisplayUnique identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.

Summarytrue
Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Communication.instantiatesCanonical
Element IdCommunication.instantiatesCanonical
Definition

The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.

Short DisplayInstantiates FHIR protocol or definition
Cardinality0..*
Typecanonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)
Summarytrue
Communication.instantiatesUri
Element IdCommunication.instantiatesUri
Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.

Short DisplayInstantiates external protocol or definition
Cardinality0..*
Typeuri
Summarytrue
Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

Communication.basedOn
Element IdCommunication.basedOn
Definition

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

Short DisplayRequest fulfilled by this communication
Cardinality0..*
TypeReference(Any)
Alternate Namesfulfills
Summarytrue
Comments

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

Communication.partOf
Element IdCommunication.partOf
Definition

A larger event (e.g. Communication, Procedure) of which this particular communication is a component or step.

Short DisplayPart of referenced event (e.g. Communication, Procedure)
Cardinality0..*
TypeReference(Any)
Alternate Namescontainer
Summarytrue
Comments

The event the communication was part of - e.g. if you disclosed as "part" of counselling, it would be partOf that Procedure.

Communication.inResponseTo
Element IdCommunication.inResponseTo
Definition

Prior communication that this communication is in response to.

Short DisplayReply to
Cardinality0..*
TypeReference(Communication)
Summaryfalse
Communication.status
Element IdCommunication.status
Definition

The status of the transmission.

Short Displaypreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Cardinality1..1
Terminology BindingEventStatus (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
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.

Communication.statusReason
Element IdCommunication.statusReason
Definition

Captures the reason for the current state of the Communication.

Short DisplayReason for current status
Cardinality0..1
Terminology BindingCommunication Not Done Reason (Example)
TypeCodeableConcept
Alternate NamesSuspended Reason; Cancelled Reason
Summarytrue
Comments

This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

Communication.category
Element IdCommunication.category
Definition

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

Short DisplayMessage category
Cardinality0..*
Terminology BindingCommunication Category (Example)
TypeCodeableConcept
Summaryfalse
Comments

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

Communication.priority
Element IdCommunication.priority
Definition

Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.

Short Displayroutine | urgent | asap | stat
Cardinality0..1
Terminology BindingRequestPriority (Required)
Typecode
Meaning if MissingIf missing, this communication should be treated with normal priority
Summarytrue
Comments

Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.

Communication.medium
Element IdCommunication.medium
Definition

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

Short DisplayA channel of communication
Cardinality0..*
Terminology BindingParticipationMode icon (Example)
TypeCodeableConcept
Summaryfalse
Communication.subject
Element IdCommunication.subject
Definition

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

Short DisplayFocus of message
Cardinality0..1
TypeReference(Patient | Group)
Alternate Namespatient
Summarytrue
Communication.topic
Element IdCommunication.topic
Definition

Description of the purpose/content, similar to a subject line in an email.

Short DisplayDescription of the purpose/content
Cardinality0..1
Terminology BindingCommunication Topic (Example)
TypeCodeableConcept
Summaryfalse
Comments

Communication.topic.text can be used without any codings.

Communication.about
Element IdCommunication.about
Definition

Other resources that pertain to this communication and to which this communication should be associated.

Short DisplayResources that pertain to this communication
Cardinality0..*
TypeReference(Any)
Summaryfalse
Comments

Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.

Communication.encounter
Element IdCommunication.encounter
Definition

The Encounter during which this Communication was created or to which the creation of this record is tightly associated.

Short DisplayThe Encounter during which this Communication was created
Cardinality0..1
TypeReference(Encounter)
Summarytrue
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

Communication.sent
Element IdCommunication.sent
Definition

The time when this communication was sent.

Short DisplayWhen sent
Cardinality0..1
TypedateTime
Summaryfalse
Communication.received
Element IdCommunication.received
Definition

The time when this communication arrived at the destination.

Short DisplayWhen received
Cardinality0..1
TypedateTime
Summaryfalse
Communication.recipient
Element IdCommunication.recipient
Definition

The entity (e.g. person, organization, clinical information system, care team or device) which is the target of the communication.

Short DisplayWho the information is shared with
Cardinality0..*
TypeReference(CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Endpoint)
Summaryfalse
Comments

If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).

Communication.sender
Element IdCommunication.sender
Definition

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

Short DisplayWho shares the information
Cardinality0..1
TypeReference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService | Endpoint | CareTeam)
Summaryfalse
Communication.reason
Element IdCommunication.reason
Definition

The reason or justification for the communication.

Short DisplayIndication for message
Cardinality0..*
Terminology BindingSNOMED CT Clinical Findings (Example)
TypeCodeableReference(Any)
Summarytrue
Comments

Textual reasons can be captured using reason.concept.text.

Communication.payload
Element IdCommunication.payload
Definition

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

Short DisplayMessage payload
Cardinality0..*
Summaryfalse
Communication.payload.content[x]
Element IdCommunication.payload.content[x]
Definition

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

Short DisplayMessage part content
Cardinality1..1
TypeAttachment|Reference(Any)|CodeableConcept
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Summaryfalse
Comments

The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.

If the content isn't codified, contentCodeableConcept.text can be used.

When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.

Communication.note
Element IdCommunication.note
Definition

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

Short DisplayComments made about the communication
Cardinality0..*
TypeAnnotation
Summaryfalse