0.3.0 - Second STU ballot

This page is part of a downloaded copy of this specification. This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.3.0: STU 1 Ballot 2) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

## StructureDefinition: PractitionerSTU3 - Detailed Descriptions

Definitions for the profile-practitioner-stu3 Profile.

1. Practitioner
Definition | This is basic constraint on provider for use in US Core resources.
Control | 0..*
Alternate Names | Provider
Comments | Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?
Invariants | Defined on this element dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty()) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
2. Practitioner.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
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.
3. 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.
Control | 0..1
Type | Meta
4. 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.
Control | 0..1
Type | uri
Is Modifier | true
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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
5. Practitioner.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | A human language. The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable Max Binding: All Languages
Type | code
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).
6. 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.
Control | 0..1 This element is affected by the following invariants: dom-1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
7. 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.
Control | 0..*
Type | Resource
Alternate Names | inline 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.
8. 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, 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.
9. 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.
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensions, 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.
10. Practitioner.identifier
Definition | An identifier that applies to this person in this role.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..*
Type | Identifier
Must Support | true
Requirements | Either id or name is needed.
11. Practitioner.identifier.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
12. 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, 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.
13. Practitioner.identifier.use
Definition | The purpose of this identifier.
Control | 0..1
Binding | Identifies the purpose for this identifier, if known . The codes SHALL be taken from IdentifierUse
Type | code
Is Modifier | true
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.
14. Practitioner.identifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Control | 0..1
Binding | A 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
Type | CodeableConcept
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.
15. Practitioner.identifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Control | 1..1
Type | uri
Must Support | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments | NPI should be used as the identifier system in the US, Tax id is allowed, Local id is allowed in addition to an 'authoritative' identifier.
Example | General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
16. Practitioner.identifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Control | 1..1
Type | string
Must Support | true
Comments | ​If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
Example | General:123456
17. Practitioner.identifier.period
Definition | Time period during which identifier is/was valid for use.
Control | 0..1
Type | Period
18. Practitioner.identifier.assigner
Definition | Organization that issued/manages the identifier.
Control | 0..1
Type | Reference(Organization)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
19. Practitioner.identifier:NPIIdentifier
Definition | An identifier that applies to this person in this role.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..1
Type | Identifier
Must Support | true
Requirements | Either id or name is needed.
20. Practitioner.identifier:NPIIdentifier.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
21. Practitioner.identifier:NPIIdentifier.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.
Control | 0..*
Type | Extension
Alternate Names | extensions, 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.
22. Practitioner.identifier:NPIIdentifier.use
Definition | The purpose of this identifier.
Control | 0..1
Binding | Identifies the purpose for this identifier, if known . The codes SHALL be taken from IdentifierUse
Type | code
Is Modifier | true
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.
23. Practitioner.identifier:NPIIdentifier.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Control | 0..1
Binding | A 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
Type | CodeableConcept
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.
24. Practitioner.identifier:NPIIdentifier.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Control | 1..1
Type | uri
Must Support | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Comments | NPI should be used as the identifier system in the US, Tax id is allowed, Local id is allowed in addition to an 'authoritative' identifier.
Fixed Value | http://hl7.org/fhir/sid/us-npi
Example | General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
25. Practitioner.identifier:NPIIdentifier.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Control | 1..1
Type | string
Must Support | true
Comments | ​If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension.
Example | General:123456
26. Practitioner.identifier:NPIIdentifier.period
Definition | Time period during which identifier is/was valid for use.
Control | 0..1
Type | Period
27. Practitioner.identifier:NPIIdentifier.assigner
Definition | Organization that issued/manages the identifier.
Control | 0..1
Type | Reference(Organization)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
28. Practitioner.active
Definition | Whether this practitioner's record is in active use.
Control | 0..1
Type | boolean
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 Value | true
29. Practitioner.name
Definition | The name(s) associated with the practitioner.
Control | 1..1
Type | HumanName
Must Support | true
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.
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: There is more than 1 name Use = usual Period is current to the date of the usage Use = official Other order as decided by internal business rules.
30. Practitioner.name.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
31. 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, 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.
32. Practitioner.name.use
Definition | Identifies the purpose for this name.
Control | 0..1
Binding | The use of a human name The codes SHALL be taken from NameUse
Type | code
Is Modifier | true
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.
33. Practitioner.name.text
Definition | A full text representation of the name.
Control | 0..1
Type | string
Requirements | A renderable, unencoded form.
Comments | Can provide both a text representation and structured parts.
34. 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.
Control | 1..1
Type | string
Must Support | true
Alternate Names | surname
Comments | Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
35. Practitioner.name.given
Definition | Given name.
Control | 0..*
Type | string
Alternate Names | first name, middle name
Comments | If only initials are recorded, they may be used in place of the full name. Not called "first name" since given names do not always come first.
36. 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.
Control | 0..*
Type | string
37. 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.
Control | 0..*
Type | string
38. Practitioner.name.period
Definition | Indicates the period of time when this name was valid for the named person.
Control | 0..1
Type | Period
Requirements | Allows names to be placed in historical context.
39. Practitioner.telecom
Definition | A contact detail for the practitioner, e.g. a telephone number or an email address.
Control | 0..*
Type | ContactPoint
Requirements | Need to know how to reach a practitioner independent to any roles the practitioner may have.
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 These typically will have home numbers, or mobile numbers that are not role specific.
40. 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.
Control | 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.
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).
41. Practitioner.gender
Definition | Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.
Control | 0..1
Binding | The gender of a person used for administrative purposes. The codes SHALL be taken from AdministrativeGender
Type | code
Requirements | Needed to address the person correctly.
42. Practitioner.birthDate
Definition | The date of birth for the practitioner.
Control | 0..1
Type | date
Requirements | Needed for identification.
43. Practitioner.photo
Definition | Image of the person.
Control | 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.
44. Practitioner.qualification
Definition | Qualifications obtained by training and certification.
Control | 0..*
Type | BackboneElement
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
45. Practitioner.qualification.id
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
46. 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, 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.
47. 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.
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensions, 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.
48. Practitioner.qualification.identifier
Definition | An identifier that applies to this person's qualification in this role.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Requirements | Often, specific identities are assigned for the qualification.
49. Practitioner.qualification.code
Definition | Coded representation of the qualification.
Control | 1..1
Binding | Specific qualification the practitioner has to provide a service For example codes, see v2 table 0360, Version 2.7
Type | CodeableConcept
Must Support | true
50. Practitioner.qualification.period
Definition | Period during which the qualification is valid.
Control | 0..1
Type | Period
Requirements | Qualifications are often for a limited period of time, and can be revoked.
51. Practitioner.qualification.issuer
Definition | Organization that regulates and issues the qualification.
Control | 0..1
Type | Reference(Organization)
52. Practitioner.communication
Definition | A language the practitioner is able to use in patient communication.
Control | 0..*
Binding | A human language. The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable Max Binding: All Languages
Type | CodeableConcept
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.