R6 Ballot (2nd Draft)

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Patient Administration icon Work GroupMaturity Level: 5 Trial UseSecurity Category: Individual Compartments: Practitioner

Detailed Descriptions for the elements in the Practitioner resource.

Practitioner
Element Id Practitioner
Definition

A person who is directly or indirectly involved in the provisioning of healthcare or related services.

Short Display A person with a formal responsibility in the provisioning of healthcare or related services
Cardinality 0..*
Type DomainResource
Requirements

Need to track doctors, staff, locums etc. for both healthcare practitioners, funders, etc.

Summary false
Practitioner.identifier
Element Id Practitioner.identifier
Definition

An identifier that applies to this person in this role.

Short Display An identifier for the person as this agent
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
Requirements

Often, specific identities are assigned for the agent.

Summary true
Practitioner.active
Element Id Practitioner.active
Definition

Whether this practitioner's record is in active use.

Short Display Whether this practitioner's record is in active use
Cardinality 0..1
Type boolean
Is Modifier true (Reason: This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid)
Meaning if Missing This resource is generally assumed to be active if no value is provided for the active element
Requirements

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

Summary true
Comments

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.

Practitioner.name
Element Id Practitioner.name
Definition

The name(s) associated with the practitioner.

Short Display The name(s) associated with the practitioner
Cardinality 0..*
Type HumanName
Requirements

The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

Summary true
Comments

The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

In general, select the value to be used in the ResourceReference.display based on this:

  1. There is more than 1 name
  2. Use = usual
  3. Period is current to the date of the usage
  4. Use = official
  5. Other order as decided by internal business rules.
Practitioner.telecom
Element Id Practitioner.telecom
Definition

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

Short Display A contact detail for the practitioner (that apply to all roles)
Cardinality 0..*
Type ContactPoint
Requirements

Need to know how to reach a practitioner independent to any roles the practitioner may have.

Summary true
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 to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.

Practitioner.gender
Element Id Practitioner.gender
Definition

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

Short Display male | female | other | unknown
Cardinality 0..1
Terminology Binding AdministrativeGender (Required)
Type code
Requirements

Needed to address the person correctly.

Summary true
Practitioner.birthDate
Element Id Practitioner.birthDate
Definition

The date of birth for the practitioner.

Short Display The date on which the practitioner was born
Cardinality 0..1
Type date
Requirements

Needed for identification.

Summary true
Practitioner.deceased[x]
Element Id Practitioner.deceased[x]
Definition

Indicates if the practitioner is deceased or not.

Short Display Indicates if the practitioner is deceased or not
Cardinality 0..1
Type boolean|dateTime
[x] Note See Choice of Datatypes for further information about how to use [x]
Is Modifier true (Reason: This element is labeled as a modifier because once a practitioner is marked as deceased, the record should only be used/retained for historical purposes.)
Summary true
Comments

If there's no value in the instance, it means there is no statement on whether or not the practitioner is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.

Practitioner.address
Element Id Practitioner.address
Definition

Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.

Short Display Address(es) of the practitioner that are not role specific (typically home address)
Cardinality 0..*
Type Address
Requirements

The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

Summary true
Comments

The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

Practitioner.photo
Element Id Practitioner.photo
Definition

Image of the person.

Short Display Image of the person
Cardinality 0..*
Type Attachment
Requirements

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

Summary false
Practitioner.qualification
Element Id Practitioner.qualification
Definition

The official qualifications, certifications, accreditations, training, licenses (and other types of educations/skills/capabilities) that authorize or otherwise pertain to the provision of care by the practitioner.

For example, a medical license issued by a medical board of licensure authorizing the practitioner to practice medicine within a certain locality.

Short Display Qualifications, certifications, accreditations, licenses, training, etc. pertaining to the provision of care
Cardinality 0..*
Summary false
Comments

The PractitionerRole.specialty defines the functional role that they are practicing at a given organization or location. Those specialties may or might not require a qualification, and are not defined on the practitioner.

Practitioner.qualification.identifier
Element Id Practitioner.qualification.identifier
Definition

An identifier that applies to this person's qualification.

Short Display An identifier for this qualification for the practitioner
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
Requirements

Often, specific identities are assigned for the qualification.

Summary false
Practitioner.qualification.code
Element Id Practitioner.qualification.code
Definition

Coded representation of the qualification.

Short Display Coded representation of the qualification
Cardinality 1..1
Terminology Binding hl7VS-degreeLicenseCertificate icon (Example)
Type CodeableConcept
Summary false
Practitioner.qualification.status
Element Id Practitioner.qualification.status
Definition

Qualifications often take time to attain and might be tracked during this time, and completed qualifications might not always be valid. This status concept has some overlap with period and both should be considered together. Refer to the descriptions of the codes for how the period should be interpreted.

If a qualification is revoked or otherwise cancelled, then the period is likely to be ignored, and m be related to when it was active.

Short Display Status/progress of the qualification
Cardinality 0..1
Terminology Binding Qualification Status (Preferred)
Type CodeableConcept
Summary false
Practitioner.qualification.period
Element Id Practitioner.qualification.period
Definition

Period during which the qualification is valid.

Short Display Period during which the qualification is valid
Cardinality 0..1
Type Period
Requirements

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

Summary false
Practitioner.qualification.issuer
Element Id Practitioner.qualification.issuer
Definition

Organization that regulates and issues the qualification.

Short Display Organization that regulates and issues the qualification
Cardinality 0..1
Type Reference(Organization)
Summary false
Practitioner.communication
Element Id Practitioner.communication
Definition

A language which may be used to communicate with the practitioner, often for correspondence/administrative purposes.

The PractitionerRole.communication property should be used for publishing the languages that a practitioner is able to communicate with patients (on a per Organization/Role basis).

Short Display A language which may be used to communicate with the practitioner
Cardinality 0..*
Summary false
Comments

If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Practitioner.Communication associations.

For animals, language is not a relevant field, and should be absent from the instance.

Practitioner.communication.language
Element Id Practitioner.communication.language
Definition

The language which may be used to communicate with the individual.

Short Display The language code used to communicate with the practitioner
Cardinality 1..1
Terminology Binding All Languages (Required)
Additional BindingsPurpose
Common Languages Starter Set
Type CodeableConcept
Requirements

Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

Summary false
Comments

The language is commonly represented using the ISO-639-1 alpha code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha code for the region in upper case. For example, "en" for English, or "en-US" for American English versus "en-AU" for Australian English, sgn-US for American Sign Language, sgn-NL for Dutch Sign Language, etc.

Not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Practitioner.communication.preferred
Element Id Practitioner.communication.preferred
Definition

Indicates whether or not the person prefers this language (over other languages he masters up a certain level).

Short Display Language preference indicator
Cardinality 0..1
Type boolean
Requirements

People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

Summary false
Comments

This language is specifically identified for communicating directly with the practitioner (typically un-related to patient communications).