This page is part of the Da Vinci Data Exchange for Quality Measures (DEQM) FHIR IG (v2.1.0: STU 3) based on FHIR R4. The current version which supercedes this version is 3.1.0. For a full list of available versions, see the Directory of published versions
XML representation of the practitioner-deqm resource profile.
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="practitioner-deqm"/> <text> <status value="extensions"/> <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the element">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_resource.png" alt="." style="background-color: white; background-color: inherit" title="Resource" class="hierarchy"/> <a href="StructureDefinition-practitioner-deqm-definitions.html#Practitioner">Practitioner</a><a name="Practitioner"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: black; null" title="This element has or is affected by some invariants (deqm-4)">I</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/us/qicore/STU4/StructureDefinition-qicore-practitioner.html">QICorePractitioner</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">A person with a formal responsibility in the provisioning of healthcare or related services</span><br/><span style="font-weight:bold">deqm-4: </span>Either an NPI, EIN, or CCN identifier SHALL be present</td></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck03.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-practitioner-deqm-definitions.html#Practitioner.identifier">identifier</a><a name="Practitioner.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red; font-style: italic" title="This element must be supported">S</span><span style="padding-left: 3px; padding-right: 3px; color: black; null; font-style: italic" title="This element has or is affected by some invariants (deqm-4)">I</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="font-style: italic">1</span><span style="font-style: italic">..</span><span style="font-style: italic">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="font-style: italic" href="http://hl7.org/fhir/R4/profiling.html#slicing">(Slice Definition)</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5; font-style: italic">An identifier for the person as this agent</span><br style="font-style: italic"/><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by pattern:$this</span><br style="font-style: italic"/></td></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck025.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-practitioner-deqm-definitions.html#Practitioner.identifier:ccn" title="Slice ccn">identifier:ccn</a><a name="Practitioner.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="padding-left: 3px; padding-right: 3px; color: white; background-color: red" title="This element must be supported">S</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">An identifier for the person as this agent</span><br/><span style="font-weight:bold">Required Pattern: </span><span style="color: darkgreen">At least the following</span></td></tr> <tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck0240.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_fixed.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Fixed Value" class="hierarchy"/> <a href="http://hl7.org/fhir/R4/datatypes-definitions.html#Identifier.system">system</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#uri">uri</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The namespace for the identifier value<br/><span style="font-weight: bold">Fixed Value: </span><span style="color: darkgreen">urn:oid:2.16.840.1.113883.4.336</span></td></tr> <tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="http://hl7.org/fhir/R4/help16.png" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div> </text> <url value="http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/practitioner-deqm"/> <version value="2.1.0"/> <name value="DEQMPractitionerProfile"/> <title value="DEQM Practitioner Profile"/> <status value="active"/> <experimental value="false"/> <date value="2018-06-19T00:00:00+00:00"/> <publisher value="HL7 International - Clinical Quality Information Work Group"/> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/cqi/index.cfm"/> </telecom> </contact> <description value="The DEQM Practitioner Profile defines the constraints for representing the practitioner who performed the measure or to which is attesting."/> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="US"/> </coding> </jurisdiction> <fhirVersion value="4.0.1"/> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 v2 Mapping"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="servd"/> <uri value="http://www.omg.org/spec/ServD/1.0/"/> <name value="ServD"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="Practitioner"/> <baseDefinition value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"/> <derivation value="constraint"/> <snapshot> <element id="Practitioner"> <path value="Practitioner"/> <short value="A person with a formal responsibility in the provisioning of healthcare or related services"/> <definition value="This is basic constraint on provider for use in US Core resources."/> <alias value="Provider"/> <min value="0"/> <max value="*"/> <base> <path value="Practitioner"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <xpath value="not(parent::f:contained and f:contained)"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="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"/> <expression value="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()"/> <xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/> </extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.`div`.exists()"/> <xpath value="exists(f:text/h:div)"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="deqm-4"/> <severity value="error"/> <human value="Either an NPI, EIN, or CCN identifier SHALL be present"/> <expression value="(identifier.system contains 'urn:oid:2.16.840.1.113883.4.4') or (identifier.system contains 'urn:oid:2.16.840.1.113883.4.336') or (identifier.system contains 'http://hl7.org/fhir/sid/us-npi')"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity. Role, or Act"/> </mapping> <mapping> <identity value="v2"/> <map value="PRD (as one example)"/> </mapping> <mapping> <identity value="rim"/> <map value="Role"/> </mapping> <mapping> <identity value="servd"/> <map value="Provider"/> </mapping> </element> <element id="Practitioner.id"> <path value="Practitioner.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Practitioner.meta"> <path value="Practitioner.meta"/> <short value="Metadata about the resource"/> <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Practitioner.implicitRules"> <path value="Practitioner.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/> <comment value="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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/> <isSummary value="true"/> </element> <element id="Practitioner.language"> <path value="Practitioner.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="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)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="preferred"/> <description value="A human language."/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </binding> </element> <element id="Practitioner.text"> <path value="Practitioner.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="A human-readable narrative that contains a summary of the resource and can 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."/> <comment value="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 information is added later."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="Practitioner.contained"> <path value="Practitioner.contained"/> <short value="Contained, inline Resources"/> <definition value="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."/> <comment value="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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Practitioner.extension"> <path value="Practitioner.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Practitioner.modifierExtension"> <path value="Practitioner.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="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."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Practitioner.identifier"> <path value="Practitioner.identifier"/> <slicing> <discriminator> <type value="pattern"/> <path value="$this"/> </discriminator> <rules value="open"/> </slicing> <short value="An identifier for the person as this agent"/> <definition value="An identifier that applies to this person in this role."/> <comment value="NPI must be supported as the identifier system in the US, Tax id is allowed, Local id is allowed in addition to an another identifier supplied by a jurisdictional authority such as a practitioner's *Drug Enforcement Administration (DEA)* number."/> <requirements value="Often, specific identities are assigned for the agent."/> <min value="1"/> <max value="*"/> <base> <path value="Practitioner.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <condition value="deqm-4"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="v2"/> <map value="PRD-7 (or XCN.1)"/> </mapping> <mapping> <identity value="rim"/> <map value="./id"/> </mapping> <mapping> <identity value="servd"/> <map value="./Identifiers"/> </mapping> </element> <element id="Practitioner.identifier:NPI"> <path value="Practitioner.identifier"/> <sliceName value="NPI"/> <short value="An identifier for the person as this agent"/> <definition value="An identifier that applies to this person in this role."/> <requirements value="Often, specific identities are assigned for the agent."/> <min value="0"/> <max value="1"/> <base> <path value="Practitioner.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <patternIdentifier> <system value="http://hl7.org/fhir/sid/us-npi"/> </patternIdentifier> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="v2"/> <map value="PRD-7 (or XCN.1)"/> </mapping> <mapping> <identity value="rim"/> <map value="./id"/> </mapping> <mapping> <identity value="servd"/> <map value="./Identifiers"/> </mapping> </element> <element id="Practitioner.identifier:ccn"> <path value="Practitioner.identifier"/> <sliceName value="ccn"/> <short value="An identifier for the person as this agent"/> <definition value="An identifier that applies to this person in this role."/> <comment value="NPI must be supported as the identifier system in the US, Tax id is allowed, Local id is allowed in addition to an another identifier supplied by a jurisdictional authority such as a practitioner's *Drug Enforcement Administration (DEA)* number."/> <requirements value="Often, specific identities are assigned for the agent."/> <min value="0"/> <max value="1"/> <base> <path value="Practitioner.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <patternIdentifier> <system value="urn:oid:2.16.840.1.113883.4.336"/> </patternIdentifier> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="v2"/> <map value="PRD-7 (or XCN.1)"/> </mapping> <mapping> <identity value="rim"/> <map value="./id"/> </mapping> <mapping> <identity value="servd"/> <map value="./Identifiers"/> </mapping> </element> <element id="Practitioner.active"> <path value="Practitioner.active"/> <short value="Whether this practitioner's record is in active use"/> <definition value="Whether this practitioner's record is in active use."/> <comment value="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."/> <requirements value="Need to be able to mark a practitioner record as not to be used because it was created in error."/> <min value="0"/> <max value="1"/> <base> <path value="Practitioner.active"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the active element"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="rim"/> <map value="./statusCode"/> </mapping> </element> <element id="Practitioner.name"> <path value="Practitioner.name"/> <short value="The name(s) associated with the practitioner"/> <definition value="The name(s) associated with the practitioner."/> <comment value="The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate. In general, select the value to be used in the ResourceReference.display based on this: 1. There is more than 1 name 2. Use = usual 3. Period is current to the date of the usage 4. Use = official 5. Other order as decided by internal business rules."/> <requirements value="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."/> <min value="1"/> <max value="1"/> <base> <path value="Practitioner.name"/> <min value="0"/> <max value="*"/> </base> <type> <code value="HumanName"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="XCN Components"/> </mapping> <mapping> <identity value="rim"/> <map value="./name"/> </mapping> <mapping> <identity value="servd"/> <map value="./PreferredName (GivenNames, FamilyName, TitleCode)"/> </mapping> </element> <element id="Practitioner.name.id"> <path value="Practitioner.name.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Practitioner.name.extension"> <path value="Practitioner.name.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Practitioner.name.use"> <path value="Practitioner.name.use"/> <short value="usual | official | temp | nickname | anonymous | old | maiden"/> <definition value="Identifies the purpose for this name."/> <comment value="Applications can assume that a name is current unless it explicitly says that it is temporary or old."/> <requirements value="Allows the appropriate name for a particular context of use to be selected from among a set of names."/> <min value="0"/> <max value="1"/> <base> <path value="HumanName.use"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="NameUse"/> </extension> <strength value="required"/> <description value="The use of a human name."/> <valueSet value="http://hl7.org/fhir/ValueSet/name-use|4.0.1"/> </binding> <mapping> <identity value="v2"/> <map value="XPN.7, but often indicated by which field contains the name"/> </mapping> <mapping> <identity value="rim"/> <map value="unique(./use)"/> </mapping> <mapping> <identity value="servd"/> <map value="./NamePurpose"/> </mapping> </element> <element id="Practitioner.name.text"> <path value="Practitioner.name.text"/> <short value="Text representation of the full name"/> <definition value="Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts."/> <comment value="Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part."/> <requirements value="A renderable, unencoded form."/> <min value="0"/> <max value="1"/> <base> <path value="HumanName.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="implied by XPN.11"/> </mapping> <mapping> <identity value="rim"/> <map value="./formatted"/> </mapping> </element> <element id="Practitioner.name.family"> <path value="Practitioner.name.family"/> <short value="Family name (often called 'Surname')"/> <definition value="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."/> <comment value="Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures)."/> <alias value="surname"/> <min value="1"/> <max value="1"/> <base> <path value="HumanName.family"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="XPN.1/FN.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./part[partType = FAM]"/> </mapping> <mapping> <identity value="servd"/> <map value="./FamilyName"/> </mapping> </element> <element id="Practitioner.name.given"> <path value="Practitioner.name.given"/> <short value="Given names (not always 'first'). Includes middle names"/> <definition value="Given name."/> <comment value="If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first."/> <alias value="first name"/> <alias value="middle name"/> <min value="0"/> <max value="*"/> <base> <path value="HumanName.given"/> <min value="0"/> <max value="*"/> </base> <type> <code value="string"/> </type> <orderMeaning value="Given Names appear in the correct order for presenting the name"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="XPN.2 + XPN.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./part[partType = GIV]"/> </mapping> <mapping> <identity value="servd"/> <map value="./GivenNames"/> </mapping> </element> <element id="Practitioner.name.prefix"> <path value="Practitioner.name.prefix"/> <short value="Parts that come before the name"/> <definition value="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."/> <min value="0"/> <max value="*"/> <base> <path value="HumanName.prefix"/> <min value="0"/> <max value="*"/> </base> <type> <code value="string"/> </type> <orderMeaning value="Prefixes appear in the correct order for presenting the name"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="XPN.5"/> </mapping> <mapping> <identity value="rim"/> <map value="./part[partType = PFX]"/> </mapping> <mapping> <identity value="servd"/> <map value="./TitleCode"/> </mapping> </element> <element id="Practitioner.name.suffix"> <path value="Practitioner.name.suffix"/> <short value="Parts that come after the name"/> <definition value="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."/> <min value="0"/> <max value="*"/> <base> <path value="HumanName.suffix"/> <min value="0"/> <max value="*"/> </base> <type> <code value="string"/> </type> <orderMeaning value="Suffixes appear in the correct order for presenting the name"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="XPN/4"/> </mapping> <mapping> <identity value="rim"/> <map value="./part[partType = SFX]"/> </mapping> </element> <element id="Practitioner.name.period"> <path value="Practitioner.name.period"/> <short value="Time period when name was/is in use"/> <definition value="Indicates the period of time when this name was valid for the named person."/> <requirements value="Allows names to be placed in historical context."/> <min value="0"/> <max value="1"/> <base> <path value="HumanName.period"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="XPN.13 + XPN.14"/> </mapping> <mapping> <identity value="rim"/> <map value="./usablePeriod[type="IVL<TS>"]"/> </mapping> <mapping> <identity value="servd"/> <map value="./StartDate and ./EndDate"/> </mapping> </element> <element id="Practitioner.telecom"> <path value="Practitioner.telecom"/> <short value="A contact detail for the practitioner (that apply to all roles)"/> <definition value="A contact detail for the practitioner, e.g. a telephone number or an email address."/> <comment value="Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific."/> <requirements value="Need to know how to reach a practitioner independent to any roles the practitioner may have."/> <min value="0"/> <max value="*"/> <base> <path value="Practitioner.telecom"/> <min value="0"/> <max value="*"/> </base> <type> <code value="ContactPoint"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="PRT-15, STF-10, ROL-12"/> </mapping> <mapping> <identity value="rim"/> <map value="./telecom"/> </mapping> <mapping> <identity value="servd"/> <map value="./ContactPoints"/> </mapping> </element> <element id="Practitioner.address"> <path value="Practitioner.address"/> <short value="Address(es) of the practitioner that are not role specific (typically home address)"/> <definition value="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."/> <comment value="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)."/> <requirements value="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."/> <min value="0"/> <max value="*"/> <base> <path value="Practitioner.address"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Address"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="ORC-24, STF-11, ROL-11, PRT-14"/> </mapping> <mapping> <identity value="rim"/> <map value="./addr"/> </mapping> <mapping> <identity value="servd"/> <map value="./Addresses"/> </mapping> </element> <element id="Practitioner.gender"> <path value="Practitioner.gender"/> <short value="male | female | other | unknown"/> <definition value="Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes."/> <requirements value="Needed to address the person correctly."/> <min value="0"/> <max value="1"/> <base> <path value="Practitioner.gender"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="AdministrativeGender"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="required"/> <description value="The gender of a person used for administrative purposes."/> <valueSet value="http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1"/> </binding> <mapping> <identity value="v2"/> <map value="STF-5"/> </mapping> <mapping> <identity value="rim"/> <map value="./administrativeGender"/> </mapping> <mapping> <identity value="servd"/> <map value="./GenderCode"/> </mapping> </element> <element id="Practitioner.birthDate"> <path value="Practitioner.birthDate"/> <short value="The date on which the practitioner was born"/> <definition value="The date of birth for the practitioner."/> <requirements value="Needed for identification."/> <min value="0"/> <max value="1"/> <base> <path value="Practitioner.birthDate"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="STF-6"/> </mapping> <mapping> <identity value="rim"/> <map value="./birthTime"/> </mapping> <mapping> <identity value="servd"/> <map value="(not represented in ServD)"/> </mapping> </element> <element id="Practitioner.photo"> <path value="Practitioner.photo"/> <short value="Image of the person"/> <definition value="Image of the person."/> <requirements value="Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too."/> <min value="0"/> <max value="*"/> <base> <path value="Practitioner.photo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Attachment"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="./subjectOf/ObservationEvent[code="photo"]/value"/> </mapping> <mapping> <identity value="servd"/> <map value="./ImageURI (only supports the URI reference)"/> </mapping> </element> <element id="Practitioner.qualification"> <path value="Practitioner.qualification"/> <short value="Certification, licenses, or training pertaining to the provision of care"/> <definition value="The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality."/> <min value="0"/> <max value="*"/> <base> <path value="Practitioner.qualification"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="v2"/> <map value="CER?"/> </mapping> <mapping> <identity value="rim"/> <map value=".playingEntity.playingRole[classCode=QUAL].code"/> </mapping> <mapping> <identity value="servd"/> <map value="./Qualifications"/> </mapping> </element> <element id="Practitioner.qualification.id"> <path value="Practitioner.qualification.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Practitioner.qualification.extension"> <path value="Practitioner.qualification.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Practitioner.qualification.modifierExtension"> <path value="Practitioner.qualification.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/> <comment value="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."/> <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Practitioner.qualification.identifier"> <path value="Practitioner.qualification.identifier"/> <short value="An identifier for this qualification for the practitioner"/> <definition value="An identifier that applies to this person's qualification in this role."/> <requirements value="Often, specific identities are assigned for the qualification."/> <min value="0"/> <max value="*"/> <base> <path value="Practitioner.qualification.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".playingEntity.playingRole[classCode=QUAL].id"/> </mapping> </element> <element id="Practitioner.qualification.code"> <path value="Practitioner.qualification.code"/> <short value="Coded representation of the qualification"/> <definition value="Coded representation of the qualification."/> <min value="1"/> <max value="1"/> <base> <path value="Practitioner.qualification.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Qualification"/> </extension> <strength value="example"/> <description value="Specific qualification the practitioner has to provide a service."/> <valueSet value="http://terminology.hl7.org/ValueSet/v2-2.7-0360"/> </binding> <mapping> <identity value="rim"/> <map value=".playingEntity.playingRole[classCode=QUAL].code"/> </mapping> <mapping> <identity value="servd"/> <map value="./Qualifications.Value"/> </mapping> </element> <element id="Practitioner.qualification.period"> <path value="Practitioner.qualification.period"/> <short value="Period during which the qualification is valid"/> <definition value="Period during which the qualification is valid."/> <requirements value="Qualifications are often for a limited period of time, and can be revoked."/> <min value="0"/> <max value="1"/> <base> <path value="Practitioner.qualification.period"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".playingEntity.playingRole[classCode=QUAL].effectiveTime"/> </mapping> <mapping> <identity value="servd"/> <map value="./Qualifications.StartDate and ./Qualifications.EndDate"/> </mapping> </element> <element id="Practitioner.qualification.issuer"> <path value="Practitioner.qualification.issuer"/> <short value="Organization that regulates and issues the qualification"/> <definition value="Organization that regulates and issues the qualification."/> <min value="0"/> <max value="1"/> <base> <path value="Practitioner.qualification.issuer"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".playingEntity.playingRole[classCode=QUAL].scoper"/> </mapping> </element> <element id="Practitioner.communication"> <path value="Practitioner.communication"/> <short value="A language the practitioner can use in patient communication"/> <definition value="A language the practitioner can use in patient communication."/> <comment value="The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type."/> <requirements value="Knowing which language a practitioner speaks can help in facilitating communication with patients."/> <min value="0"/> <max value="*"/> <base> <path value="Practitioner.communication"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="preferred"/> <description value="A human language."/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </binding> <mapping> <identity value="v2"/> <map value="PID-15, NK1-20, LAN-2"/> </mapping> <mapping> <identity value="rim"/> <map value="./languageCommunication"/> </mapping> <mapping> <identity value="servd"/> <map value="./Languages.LanguageSpokenCode"/> </mapping> </element> </snapshot> <differential> <element id="Practitioner"> <path value="Practitioner"/> <constraint> <key value="deqm-4"/> <severity value="error"/> <human value="Either an NPI, EIN, or CCN identifier SHALL be present"/> <expression value="(identifier.system contains 'urn:oid:2.16.840.1.113883.4.4') or (identifier.system contains 'urn:oid:2.16.840.1.113883.4.336') or (identifier.system contains 'http://hl7.org/fhir/sid/us-npi')"/> </constraint> <mustSupport value="false"/> </element> <element id="Practitioner.identifier"> <path value="Practitioner.identifier"/> <slicing> <discriminator> <type value="pattern"/> <path value="$this"/> </discriminator> <rules value="open"/> </slicing> <min value="1"/> <max value="*"/> <condition value="deqm-4"/> <mustSupport value="true"/> </element> <element id="Practitioner.identifier:ccn"> <path value="Practitioner.identifier"/> <sliceName value="ccn"/> <min value="0"/> <max value="1"/> <type> <code value="Identifier"/> </type> <patternIdentifier> <system value="urn:oid:2.16.840.1.113883.4.336"/> </patternIdentifier> <mustSupport value="true"/> </element> </differential> </StructureDefinition>