HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm CI Build

This page is part of the electronic Case Reporting (eCR) (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.1.0. For a full list of available versions, see the Directory of published versions

SD.16 StructureDefinition-rr-communication

This Communication profile represents the Reportability Response that will be created in response to an electronic Initial Case Report Composition. The sharing of the Reportability Response with clinical care will serve several functions, including to:

  • Communicate the reportability status, for the responsible PHA(s) of each condition included in the electronic Initial Case Report (eICR)
  • Identify who (a PHA or an intermediary) prepared the Reportability Response
  • Indicate whether the eICR has been sent to one or more PHA(s)
  • Identify which PHA(s) has/have been sent the eICR
  • Provide contact information for the responsible PHA(s)
  • Provide suggested or required clinical follow-up activities from the responsible PHA(s), including any additional reporting needs or infection control activities
  • Provide access to clinical support resources suggested by the responsible PHA(s) for identified reportable conditions
  • Confirm eICR receipt and processing

A Reportability Response will also, when requested, be shared with the responsible PHAs (when they have not constructed it) for their internal use, so they understand what has been shared with clinical care and, and to monitor/audit decision support algorithm effectivesness and implementation. When a condition is considered reportable to more than one PHA, the Reportability Response can be helpful in communicating reporting that has been done to other PHAs.

The Reportability Response Communication is also structured to allow:

  • Notification, alerting, routing and queueing in work or message management systems for healthcare personnel
  • Dynamic and static URIs for supplemental data collection and the provision of information resources

SD.16.1 Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-communication

Published on Wed Jan 29 20:30:08 UTC 2020 as a active by HL7 Public Health Work Group.

This profile builds on Communication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication S0..*CommunicationReportability Response Communication
... text S1..1NarrativeText narrative should conform to requirements laid out on the Reportability_Response_Narrative_Guidance page
... extension 0..*ExtensionSlice: Unordered, Open by value:url
... rr-priority-extension S0..1CodeableConceptReportability Response Priority
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-priority-extension
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.5 (extensible)
... identifier S1..1IdentifierExample General: {"system":"http://acme.org/identifiers","value":"RR12346"}
... category S1..1CodeableConceptRequired Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 88085-6
... subject S1..1Reference(eCR Patient)Patient
... topic S1..1CodeableConceptReportability Response Subject
.... text S1..1stringReportability Response Subject text
Example General: Public Health Reporting Communication: one or more conditions are reportable, or may be reportable to public health.
... encounter S0..1Reference(eICR Encounter)eICR Encounter
... sent 1..1dateTime
... recipient S1..*Reference(eCR Organization | US Core Practitioner Profile | eCR PractitionerRole)Reportability Response recipients
... sender S1..1Reference(Device | eCR Organization | US Core Practitioner Profile | eCR PractitionerRole)Author
... payload 0..*(Slice Definition)Slice: Unordered, Open by value:id
.... payload:sliceReportabilityResponseSummary S0..1BackboneElementReportability Response Summary
..... id S1..1stringFixed Value: reportability-response-summary
..... content[x] S1..1stringReportability Response Summary text
Example General: Your organization electronically submitted an initial case report to determine if reporting to public health is needed for a patient. "Zika virus disease (disorder)" is reportable to "State Department of Health". An initial case report was sent to "State Department of Health". Additional information may be required for this report.
.... payload:sliceEICRInformation S1..*BackboneElementElectronic Initial Case Report Information
..... id S1..1stringFixed Value: eicr-information
..... extension 0..*ExtensionSlice: Unordered, Open by value:url
..... rr-eicr-processing-status-extension S1..1(Complex)eICR Processing Status
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-processing-status-extension
..... eicr-initiation-type-extension S0..1CodeableConceptAlternately or Manually Initiated eICR
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-initiation-type-extension
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.11 (extensible)
..... rr-eicr-receipt-time-extension S0..1dateTimeDate and time of eICR receipt
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-receipt-time-extension
..... content[x] S1..1Reference to eICR Document Bundle or eICR CDA document
...... contentReferenceReference(eICR Document Bundle)
...... contentAttachmentAttachment
.... payload:sliceRelevantReportableCondition S0..*BackboneElementRelevant Reportable Condition
..... id S1..1stringFixed Value: relevant-reportable-condition
..... content[x] S1..1Reference(Relevant Reportable Condition PlanDefinition)Reference to Relevant Reportable Condition PlanDefinition

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication SI0..*CommunicationReportability Response Communication
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text SI1..1NarrativeText narrative should conform to requirements laid out on the Reportability_Response_Narrative_Guidance page
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... rr-priority-extension SI0..1CodeableConceptReportability Response Priority
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-priority-extension
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.5 (extensible)
... relates-to-extension SI0..2(Complex)Represents either a 'transforms' or a 'replaces' structure that this Communication is related to.
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/relates-to-extension
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier SΣI1..1IdentifierUnique identifier

Example General: {"system":"http://acme.org/identifiers","value":"RR12346"}
... instantiatesCanonical ΣI0..*canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)Instantiates FHIR protocol or definition
... instantiatesUri ΣI0..*uriInstantiates external protocol or definition
... basedOn ΣI0..*Reference(Resource)Request fulfilled by this communication
... partOf ΣI0..*Reference(Resource)Part of this action
... inResponseTo I0..*Reference(Communication)Reply to
... status ?!ΣI1..1codepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required)
... statusReason ΣI0..1CodeableConceptReason for current status
Binding: CommunicationNotDoneReason (example)
... category SI1..1CodeableConceptMessage category
Binding: CommunicationCategory (example)

Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 88085-6
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... priority ΣI0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required)
... medium I0..*CodeableConceptA channel of communication
Binding: v3 Code System ParticipationMode (example)
... subject SΣI1..1Reference(eCR Patient)Patient
... topic SI1..1CodeableConceptReportability Response Subject
Binding: CommunicationTopic (example)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI0..*CodingCode defined by a terminology system
.... text SΣI1..1stringReportability Response Subject text
Example General: Public Health Reporting Communication: one or more conditions are reportable, or may be reportable to public health.
... about I0..*Reference(Resource)Resources that pertain to this communication
... encounter SΣI0..1Reference(eICR Encounter)eICR Encounter
... sent I1..1dateTimeWhen sent
... received I0..1dateTimeWhen received
... recipient SI1..*Reference(eCR Organization | US Core Practitioner Profile | eCR PractitionerRole)Reportability Response recipients
... sender SI1..1Reference(Device | eCR Organization | US Core Practitioner Profile | eCR PractitionerRole)Author
... reasonCode ΣI0..*CodeableConceptIndication for message
Binding: SNOMEDCTClinicalFindings (example)
... reasonReference ΣI0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Why was communication done?
... payload I0..*(Slice Definition)Message payload
Slice: Unordered, Open by value:id
.... payload:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... content[x] I1..1Message part content
...... contentStringstring
...... contentAttachmentAttachment
...... contentReferenceReference(Resource)
.... payload:sliceReportabilityResponseSummary SI0..1BackboneElementReportability Response Summary
..... id S1..1stringUnique id for inter-element referencing
Fixed Value: reportability-response-summary
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... content[x] SI1..1stringReportability Response Summary text
Example General: Your organization electronically submitted an initial case report to determine if reporting to public health is needed for a patient. "Zika virus disease (disorder)" is reportable to "State Department of Health". An initial case report was sent to "State Department of Health". Additional information may be required for this report.
.... payload:sliceEICRInformation SI1..*BackboneElementElectronic Initial Case Report Information
..... id S1..1stringUnique id for inter-element referencing
Fixed Value: eicr-information
..... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
..... rr-eicr-processing-status-extension SI1..1(Complex)eICR Processing Status
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-processing-status-extension
..... eicr-initiation-type-extension SI0..1CodeableConceptAlternately or Manually Initiated eICR
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-initiation-type-extension
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.11 (extensible)
..... rr-eicr-receipt-time-extension SI0..1dateTimeDate and time of eICR receipt
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-receipt-time-extension
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... content[x] SI1..1Reference to eICR Document Bundle or eICR CDA document
...... contentReferenceReference(eICR Document Bundle)
...... contentAttachmentAttachment
.... payload:sliceRelevantReportableCondition SI0..*BackboneElementRelevant Reportable Condition
..... id S1..1stringUnique id for inter-element referencing
Fixed Value: relevant-reportable-condition
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... content[x] SI1..1Reference(Relevant Reportable Condition PlanDefinition)Reference to Relevant Reportable Condition PlanDefinition
... note I0..*AnnotationComments made about the communication

doco Documentation for this format

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication S0..*CommunicationReportability Response Communication
... text S1..1NarrativeText narrative should conform to requirements laid out on the Reportability_Response_Narrative_Guidance page
... extension 0..*ExtensionSlice: Unordered, Open by value:url
... rr-priority-extension S0..1CodeableConceptReportability Response Priority
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-priority-extension
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.5 (extensible)
... identifier S1..1IdentifierExample General: {"system":"http://acme.org/identifiers","value":"RR12346"}
... category S1..1CodeableConceptRequired Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 88085-6
... subject S1..1Reference(eCR Patient)Patient
... topic S1..1CodeableConceptReportability Response Subject
.... text S1..1stringReportability Response Subject text
Example General: Public Health Reporting Communication: one or more conditions are reportable, or may be reportable to public health.
... encounter S0..1Reference(eICR Encounter)eICR Encounter
... sent 1..1dateTime
... recipient S1..*Reference(eCR Organization | US Core Practitioner Profile | eCR PractitionerRole)Reportability Response recipients
... sender S1..1Reference(Device | eCR Organization | US Core Practitioner Profile | eCR PractitionerRole)Author
... payload 0..*(Slice Definition)Slice: Unordered, Open by value:id
.... payload:sliceReportabilityResponseSummary S0..1BackboneElementReportability Response Summary
..... id S1..1stringFixed Value: reportability-response-summary
..... content[x] S1..1stringReportability Response Summary text
Example General: Your organization electronically submitted an initial case report to determine if reporting to public health is needed for a patient. "Zika virus disease (disorder)" is reportable to "State Department of Health". An initial case report was sent to "State Department of Health". Additional information may be required for this report.
.... payload:sliceEICRInformation S1..*BackboneElementElectronic Initial Case Report Information
..... id S1..1stringFixed Value: eicr-information
..... extension 0..*ExtensionSlice: Unordered, Open by value:url
..... rr-eicr-processing-status-extension S1..1(Complex)eICR Processing Status
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-processing-status-extension
..... eicr-initiation-type-extension S0..1CodeableConceptAlternately or Manually Initiated eICR
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-initiation-type-extension
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.11 (extensible)
..... rr-eicr-receipt-time-extension S0..1dateTimeDate and time of eICR receipt
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-receipt-time-extension
..... content[x] S1..1Reference to eICR Document Bundle or eICR CDA document
...... contentReferenceReference(eICR Document Bundle)
...... contentAttachmentAttachment
.... payload:sliceRelevantReportableCondition S0..*BackboneElementRelevant Reportable Condition
..... id S1..1stringFixed Value: relevant-reportable-condition
..... content[x] S1..1Reference(Relevant Reportable Condition PlanDefinition)Reference to Relevant Reportable Condition PlanDefinition

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication SI0..*CommunicationReportability Response Communication
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text SI1..1NarrativeText narrative should conform to requirements laid out on the Reportability_Response_Narrative_Guidance page
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... rr-priority-extension SI0..1CodeableConceptReportability Response Priority
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-priority-extension
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.5 (extensible)
... relates-to-extension SI0..2(Complex)Represents either a 'transforms' or a 'replaces' structure that this Communication is related to.
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/relates-to-extension
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier SΣI1..1IdentifierUnique identifier

Example General: {"system":"http://acme.org/identifiers","value":"RR12346"}
... instantiatesCanonical ΣI0..*canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)Instantiates FHIR protocol or definition
... instantiatesUri ΣI0..*uriInstantiates external protocol or definition
... basedOn ΣI0..*Reference(Resource)Request fulfilled by this communication
... partOf ΣI0..*Reference(Resource)Part of this action
... inResponseTo I0..*Reference(Communication)Reply to
... status ?!ΣI1..1codepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required)
... statusReason ΣI0..1CodeableConceptReason for current status
Binding: CommunicationNotDoneReason (example)
... category SI1..1CodeableConceptMessage category
Binding: CommunicationCategory (example)

Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 88085-6
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... priority ΣI0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required)
... medium I0..*CodeableConceptA channel of communication
Binding: v3 Code System ParticipationMode (example)
... subject SΣI1..1Reference(eCR Patient)Patient
... topic SI1..1CodeableConceptReportability Response Subject
Binding: CommunicationTopic (example)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding ΣI0..*CodingCode defined by a terminology system
.... text SΣI1..1stringReportability Response Subject text
Example General: Public Health Reporting Communication: one or more conditions are reportable, or may be reportable to public health.
... about I0..*Reference(Resource)Resources that pertain to this communication
... encounter SΣI0..1Reference(eICR Encounter)eICR Encounter
... sent I1..1dateTimeWhen sent
... received I0..1dateTimeWhen received
... recipient SI1..*Reference(eCR Organization | US Core Practitioner Profile | eCR PractitionerRole)Reportability Response recipients
... sender SI1..1Reference(Device | eCR Organization | US Core Practitioner Profile | eCR PractitionerRole)Author
... reasonCode ΣI0..*CodeableConceptIndication for message
Binding: SNOMEDCTClinicalFindings (example)
... reasonReference ΣI0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Why was communication done?
... payload I0..*(Slice Definition)Message payload
Slice: Unordered, Open by value:id
.... payload:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... content[x] I1..1Message part content
...... contentStringstring
...... contentAttachmentAttachment
...... contentReferenceReference(Resource)
.... payload:sliceReportabilityResponseSummary SI0..1BackboneElementReportability Response Summary
..... id S1..1stringUnique id for inter-element referencing
Fixed Value: reportability-response-summary
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... content[x] SI1..1stringReportability Response Summary text
Example General: Your organization electronically submitted an initial case report to determine if reporting to public health is needed for a patient. "Zika virus disease (disorder)" is reportable to "State Department of Health". An initial case report was sent to "State Department of Health". Additional information may be required for this report.
.... payload:sliceEICRInformation SI1..*BackboneElementElectronic Initial Case Report Information
..... id S1..1stringUnique id for inter-element referencing
Fixed Value: eicr-information
..... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
..... rr-eicr-processing-status-extension SI1..1(Complex)eICR Processing Status
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-processing-status-extension
..... eicr-initiation-type-extension SI0..1CodeableConceptAlternately or Manually Initiated eICR
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-initiation-type-extension
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.113883.10.20.15.2.5.11 (extensible)
..... rr-eicr-receipt-time-extension SI0..1dateTimeDate and time of eICR receipt
URL: http://hl7.org/fhir/us/ecr/StructureDefinition/rr-eicr-receipt-time-extension
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... content[x] SI1..1Reference to eICR Document Bundle or eICR CDA document
...... contentReferenceReference(eICR Document Bundle)
...... contentAttachmentAttachment
.... payload:sliceRelevantReportableCondition SI0..*BackboneElementRelevant Reportable Condition
..... id S1..1stringUnique id for inter-element referencing
Fixed Value: relevant-reportable-condition
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... content[x] SI1..1Reference(Relevant Reportable Condition PlanDefinition)Reference to Relevant Reportable Condition PlanDefinition
... note I0..*AnnotationComments made about the communication

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron