Da Vinci - Coverage Requirements Discovery
2.0.1 - STU 2
Da Vinci - Coverage Requirements Discovery
2.0.1 - STU 2
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. For a full list of available versions, see the Directory of published versions
| 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.
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:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from USCorePractitionerProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Practitioner | USCorePractitionerProfile | |||
  identifier:NPI | 1..1 | Identifier | An identifier for the person as this agent | |
   system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
 qualification | S | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care |
  code | S | 1..1 | CodeableConcept | Coded representation of the qualification |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Practitioner | 0..* | USCorePractitionerProfile | A person with a formal responsibility in the provisioning of healthcare or related services | |
  implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
 Slices for identifier | SΣ | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by pattern:$this |
 identifier:NPI | SΣ | 1..1 | Identifier | An identifier for the person as this agent Required Pattern: At least the following |
  system | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
 name | SΣ | 1..* | HumanName | The name(s) associated with the practitioner |
| use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. |
| family | SΣ | 1..1 | string | Family name (often called 'Surname') |
| qualification | S | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code | S | 1..1 | CodeableConcept | Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service. |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| Practitioner.identifier:NPI.use | required | IdentifierUse |
| Practitioner.name.use | required | NameUse |
| Practitioner.qualification.code | example | v2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7) |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Practitioner | If 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-4 | error | Practitioner | 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() | |
| dom-5 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Practitioner | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Practitioner | 0..* | USCorePractitionerProfile | A person with a formal responsibility in the provisioning of healthcare or related services | |||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
 extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| Slices for identifier | SΣ | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by pattern:$this | ||||
| identifier:NPI | SΣ | 1..1 | Identifier | An identifier for the person as this agent Required Pattern: At least the following | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| use | 0..1 | code | usual | official | temp | secondary | old (If known) | |||||
| type | 0..1 | CodeableConcept | Description of identifier | |||||
| system | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi | |||||
| value | 0..1 | string | The value that is unique | |||||
| period | 0..1 | Period | Time period when id is/was valid for use | |||||
| assigner | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
| type | Σ | 0..1 | CodeableConcept | Description 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 | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | ||||
| value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
| period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
 assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| active | Σ | 0..1 | boolean | Whether this practitioner's record is in active use | ||||
| name | SΣ | 1..* | HumanName | The name(s) associated with the practitioner | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. | ||||
| text | Σ | 0..1 | string | Text representation of the full name | ||||
| family | SΣ | 1..1 | string | Family name (often called 'Surname') | ||||
| given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name | ||||
| prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name | ||||
| suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name | ||||
| period | Σ | 0..1 | Period | Time period when name was/is in use | ||||
| telecom | Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles) | ||||
| address | Σ | 0..* | Address | Address(es) of the practitioner that are not role specific (typically home address) | ||||
| gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes. | ||||
| birthDate | Σ | 0..1 | date | The date on which the practitioner was born | ||||
| photo | 0..* | Attachment | Image of the person | |||||
| qualification | S | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| identifier | 0..* | Identifier | An identifier for this qualification for the practitioner | |||||
| code | S | 1..1 | CodeableConcept | Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service. | ||||
| period | 0..1 | Period | Period during which the qualification is valid | |||||
| issuer | 0..1 | Reference(Organization) | Organization that regulates and issues the qualification | |||||
| communication | 0..* | CodeableConcept | A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language.
| |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | ||||
| Practitioner.language | preferred | CommonLanguages
| ||||
| Practitioner.identifier:NPI.use | required | IdentifierUse | ||||
| Practitioner.identifier:NPI.type | extensible | Identifier Type Codes | ||||
| Practitioner.name.use | required | NameUse | ||||
| Practitioner.gender | required | AdministrativeGender | ||||
| Practitioner.qualification.code | example | v2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7) | ||||
| Practitioner.communication | preferred | CommonLanguages
|
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Practitioner | If 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-4 | error | Practitioner | 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() | |
| dom-5 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Practitioner | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from USCorePractitionerProfile
Differential View
This structure is derived from USCorePractitionerProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Practitioner | USCorePractitionerProfile | |||
| identifier:NPI | 1..1 | Identifier | An identifier for the person as this agent | |
| system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
| qualification | S | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care |
| code | S | 1..1 | CodeableConcept | Coded representation of the qualification |
| Documentation for this format | ||||
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Practitioner | 0..* | USCorePractitionerProfile | A person with a formal responsibility in the provisioning of healthcare or related services | |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| Slices for identifier | SΣ | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by pattern:$this |
| identifier:NPI | SΣ | 1..1 | Identifier | An identifier for the person as this agent Required Pattern: At least the following |
| system | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| name | SΣ | 1..* | HumanName | The name(s) associated with the practitioner |
| use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. |
| family | SΣ | 1..1 | string | Family name (often called 'Surname') |
| qualification | S | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code | S | 1..1 | CodeableConcept | Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service. |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| Practitioner.identifier:NPI.use | required | IdentifierUse |
| Practitioner.name.use | required | NameUse |
| Practitioner.qualification.code | example | v2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7) |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Practitioner | If 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-4 | error | Practitioner | 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() | |
| dom-5 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Practitioner | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Practitioner | 0..* | USCorePractitionerProfile | A person with a formal responsibility in the provisioning of healthcare or related services | |||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| Slices for identifier | SΣ | 1..* | Identifier | An identifier for the person as this agent Slice: Unordered, Open by pattern:$this | ||||
| identifier:NPI | SΣ | 1..1 | Identifier | An identifier for the person as this agent Required Pattern: At least the following | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| use | 0..1 | code | usual | official | temp | secondary | old (If known) | |||||
| type | 0..1 | CodeableConcept | Description of identifier | |||||
| system | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi | |||||
| value | 0..1 | string | The value that is unique | |||||
| period | 0..1 | Period | Time period when id is/was valid for use | |||||
| assigner | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
| type | Σ | 0..1 | CodeableConcept | Description 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 | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | ||||
| value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
| period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| active | Σ | 0..1 | boolean | Whether this practitioner's record is in active use | ||||
| name | SΣ | 1..* | HumanName | The name(s) associated with the practitioner | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. | ||||
| text | Σ | 0..1 | string | Text representation of the full name | ||||
| family | SΣ | 1..1 | string | Family name (often called 'Surname') | ||||
| given | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name | ||||
| prefix | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name | ||||
| suffix | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name | ||||
| period | Σ | 0..1 | Period | Time period when name was/is in use | ||||
| telecom | Σ | 0..* | ContactPoint | A contact detail for the practitioner (that apply to all roles) | ||||
| address | Σ | 0..* | Address | Address(es) of the practitioner that are not role specific (typically home address) | ||||
| gender | Σ | 0..1 | code | male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes. | ||||
| birthDate | Σ | 0..1 | date | The date on which the practitioner was born | ||||
| photo | 0..* | Attachment | Image of the person | |||||
| qualification | S | 0..* | BackboneElement | Certification, licenses, or training pertaining to the provision of care | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| identifier | 0..* | Identifier | An identifier for this qualification for the practitioner | |||||
| code | S | 1..1 | CodeableConcept | Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service. | ||||
| period | 0..1 | Period | Period during which the qualification is valid | |||||
| issuer | 0..1 | Reference(Organization) | Organization that regulates and issues the qualification | |||||
| communication | 0..* | CodeableConcept | A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language.
| |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | ||||
| Practitioner.language | preferred | CommonLanguages
| ||||
| Practitioner.identifier:NPI.use | required | IdentifierUse | ||||
| Practitioner.identifier:NPI.type | extensible | Identifier Type Codes | ||||
| Practitioner.name.use | required | NameUse | ||||
| Practitioner.gender | required | AdministrativeGender | ||||
| Practitioner.qualification.code | example | v2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7) | ||||
| Practitioner.communication | preferred | CommonLanguages
|
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Practitioner | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Practitioner | If 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-4 | error | Practitioner | 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() | |
| dom-5 | error | Practitioner | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Practitioner | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from USCorePractitionerProfile
Other representations of profile: CSV, Excel, Schematron
IG © 2019+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-crd#2.0.1 based on FHIR 4.0.1. Generated 2024-01-08
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