Da Vinci - Coverage Requirements Discovery
2.0.1 - STU 2 United States of America flag

This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.0.1: STU 2.0) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: CRD Practitioner

Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner Version: 2.0.1
Standards status: Trial-use Maturity Level: 2 Computable Name: Practitioner

This profile specifies constraints on the US Core profile on the Practitioner resource to support coverage requirements discovery.

Usage


CRD Clients SHALL use this profile to resolve references to Practitioner resources passed to CRD Servers, including userId context references when invoking the following CDS Hooks:

Information provided in Must Support elements will commonly be required for CRD Servers to perform coverage requirements discovery.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner USCorePractitionerProfile
... identifier:NPI 1..1IdentifierAn identifier for the person as this agent
.... system 0..1uriThe namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
... qualification S0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... code S1..1CodeableConceptCoded representation of the qualification

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*USCorePractitionerProfileA person with a formal responsibility in the provisioning of healthcare or related services
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SΣ1..1IdentifierAn identifier for the person as this agent

Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system Σ0..1uriThe namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... family SΣ1..1stringFamily name (often called 'Surname')
... qualification S0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code S1..1CodeableConceptCoded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Practitioner.identifier:NPI.userequiredIdentifierUse
Practitioner.name.userequiredNameUse
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorPractitionerIf 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()
dom-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*USCorePractitionerProfileA person with a formal responsibility in the provisioning of healthcare or related services
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SΣ1..1IdentifierAn identifier for the person as this agent

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ0..1uriThe namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
..... value Σ0..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... active Σ0..1booleanWhether this practitioner's record is in active use
... name SΣ1..*HumanNameThe name(s) associated with the practitioner
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ0..1stringText representation of the full name
.... family SΣ1..1stringFamily name (often called 'Surname')
.... given Σ0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ0..1PeriodTime period when name was/is in use
... telecom Σ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
... address Σ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
... gender Σ0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ0..1dateThe date on which the practitioner was born
... photo 0..*AttachmentImage of the person
... qualification S0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 0..*IdentifierAn identifier for this qualification for the practitioner
.... code S1..1CodeableConceptCoded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

.... period 0..1PeriodPeriod during which the qualification is valid
.... issuer 0..1Reference(Organization)Organization that regulates and issues the qualification
... communication 0..*CodeableConceptA language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Practitioner.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Practitioner.identifier:NPI.userequiredIdentifierUse
Practitioner.identifier:NPI.typeextensibleIdentifier Type Codes
Practitioner.name.userequiredNameUse
Practitioner.genderrequiredAdministrativeGender
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
Practitioner.communicationpreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorPractitionerIf 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()
dom-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCorePractitionerProfile

Summary

Mandatory: 1 element
Must-Support: 2 elements

Maturity: 2

Differential View

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner USCorePractitionerProfile
... identifier:NPI 1..1IdentifierAn identifier for the person as this agent
.... system 0..1uriThe namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
... qualification S0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... code S1..1CodeableConceptCoded representation of the qualification

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*USCorePractitionerProfileA person with a formal responsibility in the provisioning of healthcare or related services
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SΣ1..1IdentifierAn identifier for the person as this agent

Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system Σ0..1uriThe namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... family SΣ1..1stringFamily name (often called 'Surname')
... qualification S0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code S1..1CodeableConceptCoded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Practitioner.identifier:NPI.userequiredIdentifierUse
Practitioner.name.userequiredNameUse
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorPractitionerIf 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()
dom-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*USCorePractitionerProfileA person with a formal responsibility in the provisioning of healthcare or related services
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*IdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SΣ1..1IdentifierAn identifier for the person as this agent

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ0..1uriThe namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
..... value Σ0..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... active Σ0..1booleanWhether this practitioner's record is in active use
... name SΣ1..*HumanNameThe name(s) associated with the practitioner
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ0..1stringText representation of the full name
.... family SΣ1..1stringFamily name (often called 'Surname')
.... given Σ0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ0..1PeriodTime period when name was/is in use
... telecom Σ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
... address Σ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
... gender Σ0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ0..1dateThe date on which the practitioner was born
... photo 0..*AttachmentImage of the person
... qualification S0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 0..*IdentifierAn identifier for this qualification for the practitioner
.... code S1..1CodeableConceptCoded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

.... period 0..1PeriodPeriod during which the qualification is valid
.... issuer 0..1Reference(Organization)Organization that regulates and issues the qualification
... communication 0..*CodeableConceptA language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Practitioner.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Practitioner.identifier:NPI.userequiredIdentifierUse
Practitioner.identifier:NPI.typeextensibleIdentifier Type Codes
Practitioner.name.userequiredNameUse
Practitioner.genderrequiredAdministrativeGender
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
Practitioner.communicationpreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorPractitionerIf 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()
dom-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from USCorePractitionerProfile

Summary

Mandatory: 1 element
Must-Support: 2 elements

Maturity: 2

 

Other representations of profile: CSV, Excel, Schematron