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8.37 Resource OrganizationAffiliation - Content

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Work Group

Maturity Level: 1

Trial Use

Security Category: Business

Compartments: No defined compartments

Defines an affiliation/association/relationship between 2 distinct organizations, that is not a part-of relationship/sub-division relationship.

8.37.1 Scope and Usage

A relationship between 2 organizations over a period of time, where the entities are separate business entities. The relationship can optionally include details of locations/services from the participating organization.

The OrganizationAffiliation enables defining non-hierarchical relationships between organizations. For example:

One organization may provide services to another organization
e.g. An agency service providing casual staff, a radiology service, a diagnostic lab, catering services, community care services etc.
Two or more organizations may form a partnership or joint venture
An organization may be a member of an association, but not owned by it
e.g. a hospital is a member the American Hospital Association, a hospital is a member of a health information exchange network
Spotless Cleaning Services (participatingOrganization) is a supplier (code) to General Hospital (organization)
General Hospital (participatingOrganization) is a member (code) of Eastern HIE (organization)

8.37.2 Boundaries and Relationships

The Organization.partOf is used to form a hierarchical relationships within an organization which eventually resolves to a single organization. Each child in the tree is a subdivision of the parent.
The OrganizationAffiliation is used to describe the relationship between two distinct organizations. It does not require a hierarchical relationship. A resource instance is for a singular linkage between 2 organizations (it does not contain all members), to create multiple affiliations, create additional resources for the other relationship between other organizations.
Each instance contains its own period, and optionally links to specific related services/locations that are available. These referenced locations/services should be associated with the participating organization, and are available to the primary organization.

This resource should not be used when the affiliates are part of a single organization.

8.37.3 References to this Resource

No references for this Resource.

Structure

Name	Flags	Card.	Type	Description & Constraints
OrganizationAffiliation	TU		DomainResource	Defines an affiliation/association/relationship between 2 distinct organizations, that is not a part-of relationship/sub-division relationship Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Business identifiers that are specific to this role
active	Σ	0..1	boolean	Whether this organization affiliation record is in active use
period	Σ	0..1	Period	The period during which the participatingOrganization is affiliated with the primary organization
organization	Σ	0..1	Reference(Organization)	Organization where the role is available
participatingOrganization	Σ	0..1	Reference(Organization)	Organization that provides/performs the role (e.g. providing services or is a member of)
network	Σ	0..*	Reference(Organization)	The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
code	Σ	0..*	CodeableConcept	Definition of the role the participatingOrganization plays Binding: Organization Affiliation Role (Example)
specialty	Σ	0..*	CodeableConcept	Specific specialty of the participatingOrganization in the context of the role Binding: Practice Setting Code Value Set (Preferred)
location	Σ	0..*	Reference(Location)	The location(s) at which the role occurs
healthcareService		0..*	Reference(HealthcareService)	Healthcare services provided through the role
contact	C	0..*	ExtendedContactDetail	Official contact details at the participatingOrganization relevant to this Affiliation + Rule: The telecom of an organization can never be of use 'home' + Rule: The address of an organization can never be of use 'home'
endpoint		0..*	Reference(Endpoint)	Technical endpoints providing access to services operated for this role
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<OrganizationAffiliation xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifiers that are specific to this role --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this organization affiliation record is in active use -->
 <period><!-- 0..1 Period The period during which the participatingOrganization is affiliated with the primary organization --></period>
 <organization><!-- 0..1 Reference(Organization) Organization where the role is available --></organization>
 <participatingOrganization><!-- 0..1 Reference(Organization) Organization that provides/performs the role (e.g. providing services or is a member of) --></participatingOrganization>
 <network><!-- 0..* Reference(Organization) The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined) --></network>
 <code><!-- 0..* CodeableConcept Definition of the role the participatingOrganization plays --></code>
 <specialty><!-- 0..* CodeableConcept Specific specialty of the participatingOrganization in the context of the role --></specialty>
 <location><!-- 0..* Reference(Location) The location(s) at which the role occurs --></location>
 <healthcareService><!-- 0..* Reference(HealthcareService) Healthcare services provided through the role --></healthcareService>
 <contact><!-- 0..* ExtendedContactDetail Official contact details at the participatingOrganization relevant to this Affiliation --></contact>
 <endpoint><!-- 0..* Reference(Endpoint) Technical endpoints providing access to services operated for this role --></endpoint>
</OrganizationAffiliation>

JSON Template

{
  "resourceType" : "OrganizationAffiliation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifiers that are specific to this role
  "active" : <boolean>, // Whether this organization affiliation record is in active use
  "period" : { Period }, // The period during which the participatingOrganization is affiliated with the primary organization
  "organization" : { Reference(Organization) }, // Organization where the role is available
  "participatingOrganization" : { Reference(Organization) }, // Organization that provides/performs the role (e.g. providing services or is a member of)
  "network" : [{ Reference(Organization) }], // The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
  "code" : [{ CodeableConcept }], // Definition of the role the participatingOrganization plays
  "specialty" : [{ CodeableConcept }], // Specific specialty of the participatingOrganization in the context of the role
  "location" : [{ Reference(Location) }], // The location(s) at which the role occurs
  "healthcareService" : [{ Reference(HealthcareService) }], // Healthcare services provided through the role
  "contact" : [{ ExtendedContactDetail }], // Official contact details at the participatingOrganization relevant to this Affiliation
  "endpoint" : [{ Reference(Endpoint) }] // Technical endpoints providing access to services operated for this role
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:OrganizationAffiliation;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business identifiers that are specific to this role
  fhir:active [ boolean ] ; # 0..1 Whether this organization affiliation record is in active use
  fhir:period [ Period ] ; # 0..1 The period during which the participatingOrganization is affiliated with the primary organization
  fhir:organization [ Reference(Organization) ] ; # 0..1 Organization where the role is available
  fhir:participatingOrganization [ Reference(Organization) ] ; # 0..1 Organization that provides/performs the role (e.g. providing services or is a member of)
  fhir:network  ( [ Reference(Organization) ] ... ) ; # 0..* The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
  fhir:code  ( [ CodeableConcept ] ... ) ; # 0..* Definition of the role the participatingOrganization plays
  fhir:specialty  ( [ CodeableConcept ] ... ) ; # 0..* Specific specialty of the participatingOrganization in the context of the role
  fhir:location  ( [ Reference(Location) ] ... ) ; # 0..* The location(s) at which the role occurs
  fhir:healthcareService  ( [ Reference(HealthcareService) ] ... ) ; # 0..* Healthcare services provided through the role
  fhir:contact  ( [ ExtendedContactDetail ] ... ) ; # 0..* Official contact details at the participatingOrganization relevant to this Affiliation
  fhir:endpoint  ( [ Reference(Endpoint) ] ... ) ; # 0..* Technical endpoints providing access to services operated for this role
]

Changes from both R4 and R4B

OrganizationAffiliation

OrganizationAffiliation.contact

Added Element

OrganizationAffiliation.telecom

Deleted (-> OrganizationAffiliation.contact.telecom)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Structure

Name	Flags	Card.	Type	Description & Constraints
OrganizationAffiliation	TU		DomainResource	Defines an affiliation/association/relationship between 2 distinct organizations, that is not a part-of relationship/sub-division relationship Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Business identifiers that are specific to this role
active	Σ	0..1	boolean	Whether this organization affiliation record is in active use
period	Σ	0..1	Period	The period during which the participatingOrganization is affiliated with the primary organization
organization	Σ	0..1	Reference(Organization)	Organization where the role is available
participatingOrganization	Σ	0..1	Reference(Organization)	Organization that provides/performs the role (e.g. providing services or is a member of)
network	Σ	0..*	Reference(Organization)	The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
code	Σ	0..*	CodeableConcept	Definition of the role the participatingOrganization plays Binding: Organization Affiliation Role (Example)
specialty	Σ	0..*	CodeableConcept	Specific specialty of the participatingOrganization in the context of the role Binding: Practice Setting Code Value Set (Preferred)
location	Σ	0..*	Reference(Location)	The location(s) at which the role occurs
healthcareService		0..*	Reference(HealthcareService)	Healthcare services provided through the role
contact	C	0..*	ExtendedContactDetail	Official contact details at the participatingOrganization relevant to this Affiliation + Rule: The telecom of an organization can never be of use 'home' + Rule: The address of an organization can never be of use 'home'
endpoint		0..*	Reference(Endpoint)	Technical endpoints providing access to services operated for this role
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<OrganizationAffiliation xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifiers that are specific to this role --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this organization affiliation record is in active use -->
 <period><!-- 0..1 Period The period during which the participatingOrganization is affiliated with the primary organization --></period>
 <organization><!-- 0..1 Reference(Organization) Organization where the role is available --></organization>
 <participatingOrganization><!-- 0..1 Reference(Organization) Organization that provides/performs the role (e.g. providing services or is a member of) --></participatingOrganization>
 <network><!-- 0..* Reference(Organization) The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined) --></network>
 <code><!-- 0..* CodeableConcept Definition of the role the participatingOrganization plays --></code>
 <specialty><!-- 0..* CodeableConcept Specific specialty of the participatingOrganization in the context of the role --></specialty>
 <location><!-- 0..* Reference(Location) The location(s) at which the role occurs --></location>
 <healthcareService><!-- 0..* Reference(HealthcareService) Healthcare services provided through the role --></healthcareService>
 <contact><!-- 0..* ExtendedContactDetail Official contact details at the participatingOrganization relevant to this Affiliation --></contact>
 <endpoint><!-- 0..* Reference(Endpoint) Technical endpoints providing access to services operated for this role --></endpoint>
</OrganizationAffiliation>

JSON Template

{
  "resourceType" : "OrganizationAffiliation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifiers that are specific to this role
  "active" : <boolean>, // Whether this organization affiliation record is in active use
  "period" : { Period }, // The period during which the participatingOrganization is affiliated with the primary organization
  "organization" : { Reference(Organization) }, // Organization where the role is available
  "participatingOrganization" : { Reference(Organization) }, // Organization that provides/performs the role (e.g. providing services or is a member of)
  "network" : [{ Reference(Organization) }], // The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
  "code" : [{ CodeableConcept }], // Definition of the role the participatingOrganization plays
  "specialty" : [{ CodeableConcept }], // Specific specialty of the participatingOrganization in the context of the role
  "location" : [{ Reference(Location) }], // The location(s) at which the role occurs
  "healthcareService" : [{ Reference(HealthcareService) }], // Healthcare services provided through the role
  "contact" : [{ ExtendedContactDetail }], // Official contact details at the participatingOrganization relevant to this Affiliation
  "endpoint" : [{ Reference(Endpoint) }] // Technical endpoints providing access to services operated for this role
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:OrganizationAffiliation;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business identifiers that are specific to this role
  fhir:active [ boolean ] ; # 0..1 Whether this organization affiliation record is in active use
  fhir:period [ Period ] ; # 0..1 The period during which the participatingOrganization is affiliated with the primary organization
  fhir:organization [ Reference(Organization) ] ; # 0..1 Organization where the role is available
  fhir:participatingOrganization [ Reference(Organization) ] ; # 0..1 Organization that provides/performs the role (e.g. providing services or is a member of)
  fhir:network  ( [ Reference(Organization) ] ... ) ; # 0..* The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
  fhir:code  ( [ CodeableConcept ] ... ) ; # 0..* Definition of the role the participatingOrganization plays
  fhir:specialty  ( [ CodeableConcept ] ... ) ; # 0..* Specific specialty of the participatingOrganization in the context of the role
  fhir:location  ( [ Reference(Location) ] ... ) ; # 0..* The location(s) at which the role occurs
  fhir:healthcareService  ( [ Reference(HealthcareService) ] ... ) ; # 0..* Healthcare services provided through the role
  fhir:contact  ( [ ExtendedContactDetail ] ... ) ; # 0..* Official contact details at the participatingOrganization relevant to this Affiliation
  fhir:endpoint  ( [ Reference(Endpoint) ] ... ) ; # 0..* Technical endpoints providing access to services operated for this role
]

Changes from both R4 and R4B

OrganizationAffiliation

OrganizationAffiliation.contact

Added Element

OrganizationAffiliation.telecom

Deleted (-> OrganizationAffiliation.contact.telecom)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

8.37.4.1 Terminology Bindings

Path	ValueSet	Type	Documentation
OrganizationAffiliation.code	OrganizationAffiliationRole	Example	This example value set defines a set of codes that can be used to indicate the role of one Organization in relation to another.
OrganizationAffiliation.specialty	PracticeSettingCodeValueSet	Preferred	This is the code representing the clinical specialty of the clinician or provider who interacted with, treated, or provided a service to/for the patient. The value set used for clinical specialty has been limited by HITSP to the value set reproduced from HITSP C80 Table 2-149 Clinical Specialty Value Set Definition.

Path

ValueSet

Type

Documentation

OrganizationAffiliation.code

OrganizationAffiliationRole

Example

This example value set defines a set of codes that can be used to indicate the role of one Organization in relation to another.

OrganizationAffiliation.specialty

PracticeSettingCodeValueSet

Preferred

This is the code representing the clinical specialty of the clinician or provider who interacted with, treated, or provided a service to/for the patient. The value set used for clinical specialty has been limited by HITSP to the value set reproduced from HITSP C80 Table 2-149 Clinical Specialty Value Set Definition.

8.37.4.2 Constraints

UniqueKey

Level

Location

Description

Expression

org-3

Rule

OrganizationAffiliation.contact

The telecom of an organization can never be of use 'home'

telecom.where(use = 'home').empty()

org-4

Rule

OrganizationAffiliation.contact

The address of an organization can never be of use 'home'

address.where(use = 'home').empty()

8.37.5 Notes:

Multiple instances of an OrganizationAffilitiation may exist between the same 2 organizations if a specific combination of the other related properties is required, or has a different period of usage.
Some systems record a collection of service values for a single location, others record the single service and the list of locations it is available. Both are acceptable options for representing this data.
If the HealthcareService contains more locations than specified in the Affilition, then only those in the Affiliation are relevant in the OrganizationAffiliation, it cannot introduce new locations not covered by the HealthcareService.
Conversely if no Locations are specified, then it can be assumed that all locations are available.
For some types of affiliation the HealthcareService might not be relevant and be empty, and location could be included.

8.37.6 Joint Ventures

With a joint venture between multiple organizations, a seperate Organization is created which represents the Venture. Each Organization in the venture is created through a seperate OrganizationAffiliation resource with the telecom details provided in each being the contact point to call for enquiries relating to their affiliation in the venture.

8.37.7 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
active	token	Whether this organization affiliation record is in active use	OrganizationAffiliation.active
date	date	The period during which the participatingOrganization is affiliated with the primary organization	OrganizationAffiliation.period
email	token	A value in an email contact	OrganizationAffiliation.contact.telecom.where(system='email')
endpoint	reference	Technical endpoints providing access to services operated for this role	OrganizationAffiliation.endpoint (Endpoint)
identifier	token	An organization affiliation's Identifier	OrganizationAffiliation.identifier
location	reference	The location(s) at which the role occurs	OrganizationAffiliation.location (Location)
network	reference	Health insurance provider network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)	OrganizationAffiliation.network (Organization)
participating-organization	reference	The organization that provides services to the primary organization	OrganizationAffiliation.participatingOrganization (Organization)
phone	token	A value in a phone contact	OrganizationAffiliation.contact.telecom.where(system='phone')
primary-organization	reference	The organization that receives the services from the participating organization	OrganizationAffiliation.organization (Organization)
role	token	Definition of the role the participatingOrganization plays	OrganizationAffiliation.code
service	reference	Healthcare services provided through the role	OrganizationAffiliation.healthcareService (HealthcareService)
specialty	token	Specific specialty of the participatingOrganization in the context of the role	OrganizationAffiliation.specialty
telecom	token	The value in any kind of contact	OrganizationAffiliation.contact.telecom