FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 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 . Page versions: R5 R4B R4 R3 R2

8.20 Resource Communication - Content

Patient Care Work GroupMaturity Level: 2 Trial UseCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

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.

8.20.1 Scope and Usage

Communication is one of the event resources in the FHIR workflow specification.

This resource is a record of a communication. 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, or devices. Communication use cases include:

  • A reminder or alert delivered to a responsible provider
  • A recorded notification from the nurse that a patient's temperature exceeds a value
  • A notification to a public health agency of a patient presenting with a communicable disease reportable to the public health agency
  • Patient educational material sent by a provider to a patient

Non-patient specific communication use cases may include:

  • A nurse call from a hall bathroom
  • Advisory for battery service from a pump

8.20.2 Boundaries and Relationships

This resource is a record of a communication that has occurred. It does not represent the actual flow of communication. While AuditEvent can track electronic disclosures of information, it cannot track conversations, phone calls, letters and other interactions that are not system-to-system. And even for system-to-system communications, the specific end recipients may not be known. As well, AuditEvents are not considered to be "part" of the patient record, while Communication instances are. The Communication resource is not used as a general audit mechanism to track every disclosure of every record. Rather, it is used when a clinician or other user wants to ensure a record of a particular communication is itself maintained as part of the reviewable health record.

Flag resources represent a continuous ongoing "communication" alerting anyone dealing with the patient of certain precautions to take or issues to be aware of. The flags are continuously present as an ongoing reminder. This is distinct from Communication where there is a specific intended sender and receiver and the information is delivered only once.

Communication and Encounter

The Communication is about the transfer of information (which may or may not occur as part of an encounter), while Encounter is about the coming together (in person or virtually) of a Patient with a Practitioner. Communication does not deal with the duration of a call, it represents the fact that information was transferred at a particular point in time.

The phone calls involving the Patient should be handled using Encounter. Phone calls not involving the patient (e.g. between practitioners or practitioner to relative) that are tracked for billing or other purposes can use Communication to represent the information transferred, but are not ideal to represent the call itself. A better mechanism for handling such calls will be explored in a future release.

8.20.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication IDomainResourceA record of information transmitted from a sender to a receiver
+ Not Done Reason can only be specified if NotDone is "true"
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierUnique identifier
... definition Σ0..*Reference(PlanDefinition | ActivityDefinition)Instantiates protocol or definition
... basedOn Σ0..*Reference(Any)Request fulfilled by this communication
... partOf Σ0..*Reference(Any)Part of this action
... status ?!Σ1..1codepreparation | in-progress | suspended | aborted | completed | entered-in-error
EventStatus (Required)
... notDone ?!Σ0..1booleanCommunication did not occur
... notDoneReason ΣI0..1CodeableConceptWhy communication did not occur
CommunicationNotDoneReason (Example)
... category 0..*CodeableConceptMessage category
CommunicationCategory (Example)
... medium 0..*CodeableConceptA channel of communication
v3 Code System ParticipationMode (Example)
... subject Σ0..1Reference(Patient | Group)Focus of message
... recipient 0..*Reference(Device | Organization | Patient | Practitioner | RelatedPerson | Group)Message recipient
... topic 0..*Reference(Any)Focal resources
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter or episode leading to message
... sent 0..1dateTimeWhen sent
... received 0..1dateTimeWhen received
... sender 0..1Reference(Device | Organization | Patient | Practitioner | RelatedPerson)Message sender
... reasonCode Σ0..*CodeableConceptIndication for message
SNOMED CT Clinical Findings (Example)
... reasonReference Σ0..*Reference(Condition | Observation)Why was communication done?
... payload 0..*BackboneElementMessage payload
.... content[x] 1..1Message part content
..... contentStringstring
..... contentAttachmentAttachment
..... contentReferenceReference(Any)
... note 0..*AnnotationComments made about the communication

doco Documentation for this format

UML Diagram (Legend)

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..*]A protocol, guideline, or other definition that was adhered to in whole or in part by this communication eventdefinition : Reference [0..*] PlanDefinition|ActivityDefinition An order, proposal or plan fulfilled in whole or in part by this CommunicationbasedOn : Reference [0..*] Any Part of this actionpartOf : Reference [0..*] Any The status of the transmission (this element modifies the meaning of other elements)status : code [1..1] The status of the communication. (Strength=Required)EventStatus! If true, indicates that the described communication event did not actually occur (this element modifies the meaning of other elements)notDone : boolean [0..1]Describes why the communication event did not occur in coded and/or textual formnotDoneReason : CodeableConcept [0..1] Codes for the reason why a communication was not done. (Strength=Example)CommunicationNotDoneReason?? The type of message conveyed such as alert, notification, reminder, instruction, etccategory : CodeableConcept [0..*] Codes for general categories of communications such as alerts, instruction, etc. (Strength=Example)CommunicationCategory?? A channel that was used for this communication (e.g. email, fax)medium : CodeableConcept [0..*] Codes for communication mediums such as phone, fax, email, in person, etc. (Strength=Example)v3 Code System ParticipationM...?? The patient or group that was the focus of this communicationsubject : Reference [0..1] Patient|Group The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time)recipient : Reference [0..*] Device|Organization|Patient| Practitioner|RelatedPerson|Group The resources which were responsible for or related to producing this communicationtopic : Reference [0..*] Any The encounter within which the communication was sentcontext : Reference [0..1] Encounter|EpisodeOfCare The time when this communication was sentsent : dateTime [0..1]The time when this communication arrived at the destinationreceived : dateTime [0..1]The entity (e.g. person, organization, clinical information system, or device) which was the source of the communicationsender : Reference [0..1] Device|Organization|Patient|Practitioner| RelatedPerson The reason or justification for the communicationreasonCode : CodeableConcept [0..*] Codes for describing reasons for the occurrence of a communication. (Strength=Example)SNOMED CT Clinical Findings?? Indicates another resource whose existence justifies this communicationreasonReference : Reference [0..*] Condition|Observation Additional notes or commentary about the communication by the sender, receiver or other interested partiesnote : Annotation [0..*]PayloadA communicated content (or for multi-part communications, one portion of the communication)content[x] : Type [1..1] string|Attachment|Reference(Any) Text, attachment(s), or resource(s) that was communicated to the recipientpayload[0..*]

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>
 <definition><!-- 0..* Reference(PlanDefinition|ActivityDefinition) Instantiates protocol or definition --></definition>
 <basedOn><!-- 0..* Reference(Any) Request fulfilled by this communication --></basedOn>
 <partOf><!-- 0..* Reference(Any) Part of this action --></partOf>
 <status value="[code]"/><!-- 1..1 preparation | in-progress | suspended | aborted | completed | entered-in-error -->
 <notDone value="[boolean]"/><!-- 0..1 Communication did not occur -->
 <notDoneReason><!-- ?? 0..1 CodeableConcept Why communication did not occur --></notDoneReason>
 <category><!-- 0..* CodeableConcept Message category --></category>
 <medium><!-- 0..* CodeableConcept A channel of communication --></medium>
 <subject><!-- 0..1 Reference(Patient|Group) Focus of message --></subject>
 <recipient><!-- 0..* Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson|Group) Message recipient --></recipient>
 <topic><!-- 0..* Reference(Any) Focal resources --></topic>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter or episode leading to message --></context>
 <sent value="[dateTime]"/><!-- 0..1 When sent -->
 <received value="[dateTime]"/><!-- 0..1 When received -->
 <sender><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson) Message sender --></sender>
 <reasonCode><!-- 0..* CodeableConcept Indication for message --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation) Why was communication done? --></reasonReference>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <note><!-- 0..* Annotation Comments made about the communication --></note>
</Communication>

JSON Template

{doco
  "resourceType" : "Communication",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier
  "definition" : [{ Reference(PlanDefinition|ActivityDefinition) }], // Instantiates protocol or definition
  "basedOn" : [{ Reference(Any) }], // Request fulfilled by this communication
  "partOf" : [{ Reference(Any) }], // Part of this action
  "status" : "<code>", // R!  preparation | in-progress | suspended | aborted | completed | entered-in-error
  "notDone" : <boolean>, // Communication did not occur
  "notDoneReason" : { CodeableConcept }, // C? Why communication did not occur
  "category" : [{ CodeableConcept }], // Message category
  "medium" : [{ CodeableConcept }], // A channel of communication
  "subject" : { Reference(Patient|Group) }, // Focus of message
  "recipient" : [{ Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson|Group) }], // Message recipient
  "topic" : [{ Reference(Any) }], // Focal resources
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter or episode leading to message
  "sent" : "<dateTime>", // When sent
  "received" : "<dateTime>", // When received
  "sender" : { Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson) }, // Message sender
  "reasonCode" : [{ CodeableConcept }], // Indication for message
  "reasonReference" : [{ Reference(Condition|Observation) }], // Why was communication done?
  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }
  }],
  "note" : [{ Annotation }] // Comments made about the communication
}

Turtle Template

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


[ a fhir:Communication;
  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:Communication.identifier [ Identifier ], ... ; # 0..* Unique identifier
  fhir:Communication.definition [ Reference(PlanDefinition|ActivityDefinition) ], ... ; # 0..* Instantiates protocol or definition
  fhir:Communication.basedOn [ Reference(Any) ], ... ; # 0..* Request fulfilled by this communication
  fhir:Communication.partOf [ Reference(Any) ], ... ; # 0..* Part of this action
  fhir:Communication.status [ code ]; # 1..1 preparation | in-progress | suspended | aborted | completed | entered-in-error
  fhir:Communication.notDone [ boolean ]; # 0..1 Communication did not occur
  fhir:Communication.notDoneReason [ CodeableConcept ]; # 0..1 Why communication did not occur
  fhir:Communication.category [ CodeableConcept ], ... ; # 0..* Message category
  fhir:Communication.medium [ CodeableConcept ], ... ; # 0..* A channel of communication
  fhir:Communication.subject [ Reference(Patient|Group) ]; # 0..1 Focus of message
  fhir:Communication.recipient [ Reference(Device|Organization|Patient|Practitioner|RelatedPerson|Group) ], ... ; # 0..* Message recipient
  fhir:Communication.topic [ Reference(Any) ], ... ; # 0..* Focal resources
  fhir:Communication.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter or episode leading to message
  fhir:Communication.sent [ dateTime ]; # 0..1 When sent
  fhir:Communication.received [ dateTime ]; # 0..1 When received
  fhir:Communication.sender [ Reference(Device|Organization|Patient|Practitioner|RelatedPerson) ]; # 0..1 Message sender
  fhir:Communication.reasonCode [ CodeableConcept ], ... ; # 0..* Indication for message
  fhir:Communication.reasonReference [ Reference(Condition|Observation) ], ... ; # 0..* Why was communication done?
  fhir:Communication.payload [ # 0..* Message payload
    # Communication.payload.content[x] : 1..1 Message part content. One of these 3
      fhir:Communication.payload.contentString [ string ]
      fhir:Communication.payload.contentAttachment [ Attachment ]
      fhir:Communication.payload.contentReference [ Reference(Any) ]
  ], ...;
  fhir:Communication.note [ Annotation ], ... ; # 0..* Comments made about the communication
]

Changes since DSTU2

Communication
Communication.definition
  • Added Element
Communication.basedOn
  • Renamed from requestDetail to basedOn
  • Max Cardinality changed from 1 to *
  • Type changed from Reference(CommunicationRequest) to Reference(Resource)
Communication.partOf
  • Added Element
Communication.status
  • Min Cardinality changed from 0 to 1
  • Change value set from http://hl7.org/fhir/ValueSet/communication-status to http://hl7.org/fhir/ValueSet/event-status
Communication.notDone
  • Added Element
Communication.notDoneReason
  • Added Element
Communication.category
  • Max Cardinality changed from 1 to *
Communication.subject
  • Add Reference(Group)
Communication.topic
  • Added Element
Communication.context
  • Renamed from encounter to context
  • Add Reference(EpisodeOfCare)
Communication.reasonCode
  • Renamed from reason to reasonCode
Communication.reasonReference
  • Added Element
Communication.note
  • Added Element

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.).

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication IDomainResourceA record of information transmitted from a sender to a receiver
+ Not Done Reason can only be specified if NotDone is "true"
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierUnique identifier
... definition Σ0..*Reference(PlanDefinition | ActivityDefinition)Instantiates protocol or definition
... basedOn Σ0..*Reference(Any)Request fulfilled by this communication
... partOf Σ0..*Reference(Any)Part of this action
... status ?!Σ1..1codepreparation | in-progress | suspended | aborted | completed | entered-in-error
EventStatus (Required)
... notDone ?!Σ0..1booleanCommunication did not occur
... notDoneReason ΣI0..1CodeableConceptWhy communication did not occur
CommunicationNotDoneReason (Example)
... category 0..*CodeableConceptMessage category
CommunicationCategory (Example)
... medium 0..*CodeableConceptA channel of communication
v3 Code System ParticipationMode (Example)
... subject Σ0..1Reference(Patient | Group)Focus of message
... recipient 0..*Reference(Device | Organization | Patient | Practitioner | RelatedPerson | Group)Message recipient
... topic 0..*Reference(Any)Focal resources
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter or episode leading to message
... sent 0..1dateTimeWhen sent
... received 0..1dateTimeWhen received
... sender 0..1Reference(Device | Organization | Patient | Practitioner | RelatedPerson)Message sender
... reasonCode Σ0..*CodeableConceptIndication for message
SNOMED CT Clinical Findings (Example)
... reasonReference Σ0..*Reference(Condition | Observation)Why was communication done?
... payload 0..*BackboneElementMessage payload
.... content[x] 1..1Message part content
..... contentStringstring
..... contentAttachmentAttachment
..... contentReferenceReference(Any)
... note 0..*AnnotationComments made about the communication

doco Documentation for this format

UML Diagram (Legend)

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..*]A protocol, guideline, or other definition that was adhered to in whole or in part by this communication eventdefinition : Reference [0..*] PlanDefinition|ActivityDefinition An order, proposal or plan fulfilled in whole or in part by this CommunicationbasedOn : Reference [0..*] Any Part of this actionpartOf : Reference [0..*] Any The status of the transmission (this element modifies the meaning of other elements)status : code [1..1] The status of the communication. (Strength=Required)EventStatus! If true, indicates that the described communication event did not actually occur (this element modifies the meaning of other elements)notDone : boolean [0..1]Describes why the communication event did not occur in coded and/or textual formnotDoneReason : CodeableConcept [0..1] Codes for the reason why a communication was not done. (Strength=Example)CommunicationNotDoneReason?? The type of message conveyed such as alert, notification, reminder, instruction, etccategory : CodeableConcept [0..*] Codes for general categories of communications such as alerts, instruction, etc. (Strength=Example)CommunicationCategory?? A channel that was used for this communication (e.g. email, fax)medium : CodeableConcept [0..*] Codes for communication mediums such as phone, fax, email, in person, etc. (Strength=Example)v3 Code System ParticipationM...?? The patient or group that was the focus of this communicationsubject : Reference [0..1] Patient|Group The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time)recipient : Reference [0..*] Device|Organization|Patient| Practitioner|RelatedPerson|Group The resources which were responsible for or related to producing this communicationtopic : Reference [0..*] Any The encounter within which the communication was sentcontext : Reference [0..1] Encounter|EpisodeOfCare The time when this communication was sentsent : dateTime [0..1]The time when this communication arrived at the destinationreceived : dateTime [0..1]The entity (e.g. person, organization, clinical information system, or device) which was the source of the communicationsender : Reference [0..1] Device|Organization|Patient|Practitioner| RelatedPerson The reason or justification for the communicationreasonCode : CodeableConcept [0..*] Codes for describing reasons for the occurrence of a communication. (Strength=Example)SNOMED CT Clinical Findings?? Indicates another resource whose existence justifies this communicationreasonReference : Reference [0..*] Condition|Observation Additional notes or commentary about the communication by the sender, receiver or other interested partiesnote : Annotation [0..*]PayloadA communicated content (or for multi-part communications, one portion of the communication)content[x] : Type [1..1] string|Attachment|Reference(Any) Text, attachment(s), or resource(s) that was communicated to the recipientpayload[0..*]

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>
 <definition><!-- 0..* Reference(PlanDefinition|ActivityDefinition) Instantiates protocol or definition --></definition>
 <basedOn><!-- 0..* Reference(Any) Request fulfilled by this communication --></basedOn>
 <partOf><!-- 0..* Reference(Any) Part of this action --></partOf>
 <status value="[code]"/><!-- 1..1 preparation | in-progress | suspended | aborted | completed | entered-in-error -->
 <notDone value="[boolean]"/><!-- 0..1 Communication did not occur -->
 <notDoneReason><!-- ?? 0..1 CodeableConcept Why communication did not occur --></notDoneReason>
 <category><!-- 0..* CodeableConcept Message category --></category>
 <medium><!-- 0..* CodeableConcept A channel of communication --></medium>
 <subject><!-- 0..1 Reference(Patient|Group) Focus of message --></subject>
 <recipient><!-- 0..* Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson|Group) Message recipient --></recipient>
 <topic><!-- 0..* Reference(Any) Focal resources --></topic>
 <context><!-- 0..1 Reference(Encounter|EpisodeOfCare) Encounter or episode leading to message --></context>
 <sent value="[dateTime]"/><!-- 0..1 When sent -->
 <received value="[dateTime]"/><!-- 0..1 When received -->
 <sender><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson) Message sender --></sender>
 <reasonCode><!-- 0..* CodeableConcept Indication for message --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation) Why was communication done? --></reasonReference>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <note><!-- 0..* Annotation Comments made about the communication --></note>
</Communication>

JSON Template

{doco
  "resourceType" : "Communication",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Unique identifier
  "definition" : [{ Reference(PlanDefinition|ActivityDefinition) }], // Instantiates protocol or definition
  "basedOn" : [{ Reference(Any) }], // Request fulfilled by this communication
  "partOf" : [{ Reference(Any) }], // Part of this action
  "status" : "<code>", // R!  preparation | in-progress | suspended | aborted | completed | entered-in-error
  "notDone" : <boolean>, // Communication did not occur
  "notDoneReason" : { CodeableConcept }, // C? Why communication did not occur
  "category" : [{ CodeableConcept }], // Message category
  "medium" : [{ CodeableConcept }], // A channel of communication
  "subject" : { Reference(Patient|Group) }, // Focus of message
  "recipient" : [{ Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson|Group) }], // Message recipient
  "topic" : [{ Reference(Any) }], // Focal resources
  "context" : { Reference(Encounter|EpisodeOfCare) }, // Encounter or episode leading to message
  "sent" : "<dateTime>", // When sent
  "received" : "<dateTime>", // When received
  "sender" : { Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson) }, // Message sender
  "reasonCode" : [{ CodeableConcept }], // Indication for message
  "reasonReference" : [{ Reference(Condition|Observation) }], // Why was communication done?
  "payload" : [{ // Message payload
    // content[x]: Message part content. One of these 3:
    "contentString" : "<string>"
    "contentAttachment" : { Attachment }
    "contentReference" : { Reference(Any) }
  }],
  "note" : [{ Annotation }] // Comments made about the communication
}

Turtle Template

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


[ a fhir:Communication;
  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:Communication.identifier [ Identifier ], ... ; # 0..* Unique identifier
  fhir:Communication.definition [ Reference(PlanDefinition|ActivityDefinition) ], ... ; # 0..* Instantiates protocol or definition
  fhir:Communication.basedOn [ Reference(Any) ], ... ; # 0..* Request fulfilled by this communication
  fhir:Communication.partOf [ Reference(Any) ], ... ; # 0..* Part of this action
  fhir:Communication.status [ code ]; # 1..1 preparation | in-progress | suspended | aborted | completed | entered-in-error
  fhir:Communication.notDone [ boolean ]; # 0..1 Communication did not occur
  fhir:Communication.notDoneReason [ CodeableConcept ]; # 0..1 Why communication did not occur
  fhir:Communication.category [ CodeableConcept ], ... ; # 0..* Message category
  fhir:Communication.medium [ CodeableConcept ], ... ; # 0..* A channel of communication
  fhir:Communication.subject [ Reference(Patient|Group) ]; # 0..1 Focus of message
  fhir:Communication.recipient [ Reference(Device|Organization|Patient|Practitioner|RelatedPerson|Group) ], ... ; # 0..* Message recipient
  fhir:Communication.topic [ Reference(Any) ], ... ; # 0..* Focal resources
  fhir:Communication.context [ Reference(Encounter|EpisodeOfCare) ]; # 0..1 Encounter or episode leading to message
  fhir:Communication.sent [ dateTime ]; # 0..1 When sent
  fhir:Communication.received [ dateTime ]; # 0..1 When received
  fhir:Communication.sender [ Reference(Device|Organization|Patient|Practitioner|RelatedPerson) ]; # 0..1 Message sender
  fhir:Communication.reasonCode [ CodeableConcept ], ... ; # 0..* Indication for message
  fhir:Communication.reasonReference [ Reference(Condition|Observation) ], ... ; # 0..* Why was communication done?
  fhir:Communication.payload [ # 0..* Message payload
    # Communication.payload.content[x] : 1..1 Message part content. One of these 3
      fhir:Communication.payload.contentString [ string ]
      fhir:Communication.payload.contentAttachment [ Attachment ]
      fhir:Communication.payload.contentReference [ Reference(Any) ]
  ], ...;
  fhir:Communication.note [ Annotation ], ... ; # 0..* Comments made about the communication
]

Changes since DSTU2

Communication
Communication.definition
  • Added Element
Communication.basedOn
  • Renamed from requestDetail to basedOn
  • Max Cardinality changed from 1 to *
  • Type changed from Reference(CommunicationRequest) to Reference(Resource)
Communication.partOf
  • Added Element
Communication.status
  • Min Cardinality changed from 0 to 1
  • Change value set from http://hl7.org/fhir/ValueSet/communication-status to http://hl7.org/fhir/ValueSet/event-status
Communication.notDone
  • Added Element
Communication.notDoneReason
  • Added Element
Communication.category
  • Max Cardinality changed from 1 to *
Communication.subject
  • Add Reference(Group)
Communication.topic
  • Added Element
Communication.context
  • Renamed from encounter to context
  • Add Reference(EpisodeOfCare)
Communication.reasonCode
  • Renamed from reason to reasonCode
Communication.reasonReference
  • Added Element
Communication.note
  • Added Element

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.).

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle)

8.20.3.1 Terminology Bindings

PathDefinitionTypeReference
Communication.status The status of the communication.RequiredEventStatus
Communication.notDoneReason Codes for the reason why a communication was not done.ExampleCommunicationNotDoneReason
Communication.category Codes for general categories of communications such as alerts, instruction, etc.ExampleCommunicationCategory
Communication.medium Codes for communication mediums such as phone, fax, email, in person, etc.Examplev3 Code System ParticipationMode
Communication.reasonCode Codes for describing reasons for the occurrence of a communication.ExampleSNOMED CT Clinical Findings

8.20.3.2 Constraints

  • com-1: Not Done Reason can only be specified if NotDone is "true" (expression : notDone or notDoneReason.exists().not())

Notes to reviewers:

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

8.20.3.3 Communication.sender and Communication.recepient

Communication.sender and Communication.recipient allow Patient|Practitioner|RelatedPerson - but it is not unusual to have a communication target - even a defined one - where it is unknown what kind of role the person is playing.

If the communication is to or from an individual, whose role is not known (practitioner, patient or related person), - for example, only email address is captured in the system; then RelatedPerson should be used by default.

8.20.4 Search Parameters

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

NameTypeDescriptionExpressionIn Common
based-onreferenceRequest fulfilled by this communicationCommunication.basedOn
(Any)
categorytokenMessage categoryCommunication.category
contextreferenceEncounter or episode leading to messageCommunication.context
(EpisodeOfCare, Encounter)
definitionreferenceInstantiates protocol or definitionCommunication.definition
(PlanDefinition, ActivityDefinition)
encounterreferenceEncounter leading to messageCommunication.context
(Encounter)
identifiertokenUnique identifierCommunication.identifier
mediumtokenA channel of communicationCommunication.medium
part-ofreferencePart of this actionCommunication.partOf
(Any)
patientreferenceFocus of messageCommunication.subject
(Patient)
receiveddateWhen receivedCommunication.received
recipientreferenceMessage recipientCommunication.recipient
(Practitioner, Group, Organization, Device, Patient, RelatedPerson)
senderreferenceMessage senderCommunication.sender
(Practitioner, Organization, Device, Patient, RelatedPerson)
sentdateWhen sentCommunication.sent
statustokenpreparation | in-progress | suspended | aborted | completed | entered-in-errorCommunication.status
subjectreferenceFocus of messageCommunication.subject
(Group, Patient)