QI-Core Implementation Guide
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This page is part of the Quality Improvement Core Framework (v6.0.0-ballot: STU6 (v6.0.0) Ballot 1) based on FHIR R4. The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: QiCore Communication Not Done

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone Version: 6.0.0-ballot
Active as of 2023-08-01 Computable Name: QICoreCommunicationNotDone

Profile of CommunicationNotDone for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

See the patterns page for implementation and usage patterns.

The Communication and CommunicationNotDone profiles represent the positive and negative statements for a communication event.

Examples

Negation Example using a single coded conceptCommunication of finding of Macular Edema absent not done because patient moved away.

This example meets measure intent for exclusion as defined in the following example CQL:

[CommunicationNotDone: "Macular edema absent (finding)"] MacularEdemaAbsentNotCommunicated
  with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
    such that MacularEdemaAbsentNotCommunicated.sent during EncounterDiabeticRetinopathy.period
      and ( MacularEdemaAbsentNotCommunicated.statusReason in "Medical Reason"
        or MacularEdemaAbsentNotCommunicated.statusReason in "Patient Reason"
      )

For a more complete discussion of representation of negation within QICore and quality improvement artifacts, see the Negation in QI Core topic.

Usage:

Formal Views of Profile Content

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

This structure is derived from Communication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication C0..*CommunicationA record of information transmitted from a sender to a receiver
cnd-1: to indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
... recorded S1..1dateTimeExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... status S1..1codepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Fixed Value: not-done
... statusReason S1..1CodeableConceptReason for current status
Binding: QICore Negation Reason Codes (extensible)
... topic S1..1CodeableConceptDescription of the purpose/content
Binding: CommunicationTopic (preferred): Codes describing the purpose or content of the communication.

.... notDoneValueSet S0..1canonical(ValueSet)Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Communication.statusReasonextensibleNegationReasonCodes
Communication.topicpreferredCommunicationTopic

Constraints

IdGradePath(s)DetailsRequirements
cnd-1errorCommunicationto indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
: topic.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor topic.coding.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication C0..*CommunicationA record of information transmitted from a sender to a receiver
cnd-1: to indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
... recorded S1..1dateTimeExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... status ?!SΣ1..1codepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required): The status of the communication.


Fixed Value: not-done
... statusReason SΣ1..1CodeableConceptReason for current status
Binding: QICore Negation Reason Codes (extensible)
... subject SΣ0..1Reference(QICore Patient | Group)Focus of message
... topic S1..1CodeableConceptDescription of the purpose/content
Binding: CommunicationTopic (preferred): Codes describing the purpose or content of the communication.

.... notDoneValueSet S0..1canonical(ValueSet)Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Communication.statusrequiredFixed Value: not-done
Communication.statusReasonextensibleNegationReasonCodes
Communication.topicpreferredCommunicationTopic

Constraints

IdGradePath(s)DetailsRequirements
cnd-1errorCommunicationto indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
: topic.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor topic.coding.exists()
dom-2errorCommunicationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCommunicationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCommunicationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCommunicationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCommunicationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication C0..*CommunicationA record of information transmitted from a sender to a receiver
cnd-1: to indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
... recorded S1..1dateTimeExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierUnique identifier
... instantiatesCanonical Σ0..*canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(Resource)Request fulfilled by this communication
... partOf Σ0..*Reference(Resource)Part of this action
... inResponseTo 0..*Reference(Communication)Reply to
... status ?!SΣ1..1codepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required): The status of the communication.


Fixed Value: not-done
... statusReason SΣ1..1CodeableConceptReason for current status
Binding: QICore Negation Reason Codes (extensible)
... category 0..*CodeableConceptMessage category
Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.


... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Codes indicating the relative importance of a communication.

... medium 0..*CodeableConceptA channel of communication
Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.


... subject SΣ0..1Reference(QICore Patient | Group)Focus of message
... topic S1..1CodeableConceptDescription of the purpose/content
Binding: CommunicationTopic (preferred): Codes describing the purpose or content of the communication.

.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... notDoneValueSet S0..1canonical(ValueSet)Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... about 0..*Reference(Resource)Resources that pertain to this communication
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... sent 0..1dateTimeWhen sent
... received 0..1dateTimeWhen received
... recipient 0..*Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)Message recipient
... sender 0..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)Message sender
... reasonCode Σ0..*CodeableConceptIndication for message
Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.


... reasonReference Σ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Why was communication done?
... payload 0..*BackboneElementMessage payload
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... content[x] 1..1Message part content
..... contentStringstring
..... contentAttachmentAttachment
..... contentReferenceReference(Resource)
... note 0..*AnnotationComments made about the communication

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Communication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Communication.statusrequiredFixed Value: not-done
Communication.statusReasonextensibleNegationReasonCodes
Communication.categoryexampleCommunicationCategory
Communication.priorityrequiredRequestPriority
Communication.mediumexampleParticipationMode
Communication.topicpreferredCommunicationTopic
Communication.reasonCodeexampleSNOMEDCTClinicalFindings

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from Communication

Summary

Mandatory: 4 elements
Must-Support: 6 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from Communication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication C0..*CommunicationA record of information transmitted from a sender to a receiver
cnd-1: to indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
... recorded S1..1dateTimeExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... status S1..1codepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Fixed Value: not-done
... statusReason S1..1CodeableConceptReason for current status
Binding: QICore Negation Reason Codes (extensible)
... topic S1..1CodeableConceptDescription of the purpose/content
Binding: CommunicationTopic (preferred): Codes describing the purpose or content of the communication.

.... notDoneValueSet S0..1canonical(ValueSet)Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Communication.statusReasonextensibleNegationReasonCodes
Communication.topicpreferredCommunicationTopic

Constraints

IdGradePath(s)DetailsRequirements
cnd-1errorCommunicationto indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
: topic.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor topic.coding.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication C0..*CommunicationA record of information transmitted from a sender to a receiver
cnd-1: to indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
... recorded S1..1dateTimeExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... status ?!SΣ1..1codepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required): The status of the communication.


Fixed Value: not-done
... statusReason SΣ1..1CodeableConceptReason for current status
Binding: QICore Negation Reason Codes (extensible)
... subject SΣ0..1Reference(QICore Patient | Group)Focus of message
... topic S1..1CodeableConceptDescription of the purpose/content
Binding: CommunicationTopic (preferred): Codes describing the purpose or content of the communication.

.... notDoneValueSet S0..1canonical(ValueSet)Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Communication.statusrequiredFixed Value: not-done
Communication.statusReasonextensibleNegationReasonCodes
Communication.topicpreferredCommunicationTopic

Constraints

IdGradePath(s)DetailsRequirements
cnd-1errorCommunicationto indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
: topic.extension('http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet').exists() xor topic.coding.exists()
dom-2errorCommunicationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCommunicationIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCommunicationIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCommunicationIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCommunicationA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication C0..*CommunicationA record of information transmitted from a sender to a receiver
cnd-1: to indicate what communication was not carried out, either at least one coding in the topic or a notDoneValueSet extension shall be provided
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
... recorded S1..1dateTimeExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierUnique identifier
... instantiatesCanonical Σ0..*canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(Resource)Request fulfilled by this communication
... partOf Σ0..*Reference(Resource)Part of this action
... inResponseTo 0..*Reference(Communication)Reply to
... status ?!SΣ1..1codepreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required): The status of the communication.


Fixed Value: not-done
... statusReason SΣ1..1CodeableConceptReason for current status
Binding: QICore Negation Reason Codes (extensible)
... category 0..*CodeableConceptMessage category
Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.


... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Codes indicating the relative importance of a communication.

... medium 0..*CodeableConceptA channel of communication
Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.


... subject SΣ0..1Reference(QICore Patient | Group)Focus of message
... topic S1..1CodeableConceptDescription of the purpose/content
Binding: CommunicationTopic (preferred): Codes describing the purpose or content of the communication.

.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... notDoneValueSet S0..1canonical(ValueSet)Url of a value set of activities not requested or performed
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... about 0..*Reference(Resource)Resources that pertain to this communication
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... sent 0..1dateTimeWhen sent
... received 0..1dateTimeWhen received
... recipient 0..*Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)Message recipient
... sender 0..1Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)Message sender
... reasonCode Σ0..*CodeableConceptIndication for message
Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.


... reasonReference Σ0..*Reference(Condition | Observation | DiagnosticReport | DocumentReference)Why was communication done?
... payload 0..*BackboneElementMessage payload
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... content[x] 1..1Message part content
..... contentStringstring
..... contentAttachmentAttachment
..... contentReferenceReference(Resource)
... note 0..*AnnotationComments made about the communication

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
Communication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Communication.statusrequiredFixed Value: not-done
Communication.statusReasonextensibleNegationReasonCodes
Communication.categoryexampleCommunicationCategory
Communication.priorityrequiredRequestPriority
Communication.mediumexampleParticipationMode
Communication.topicpreferredCommunicationTopic
Communication.reasonCodeexampleSNOMEDCTClinicalFindings

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from Communication

Summary

Mandatory: 4 elements
Must-Support: 6 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron