QI-Core Implementation Guide
7.0.0-ballot - STU7 Ballot United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0-ballot: STU7 (v7.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 6.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: QICore Communication

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication Version: 7.0.0-ballot
Active as of 2023-08-01 Computable Name: QICoreCommunication

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

QI Elements:
  • status: (QI) preparation | in-progress | on-hold | stopped | completed | entered-in-error | unknown
  • subject: (QI) Focus of message
  • topic: (QI) Description of the purpose/content
  • sent: (QI) When sent
  • received: (QI) When received
  • recipient: (QI) Message recipient
  • sender: (QI) Message sender
Primary code path: reasonCode
(PCPath) This element is the primary code path for this resource CQL Retrieve


NOTE TO BALLOT REVIEWERS:
  • US Core 7.0, and thus QI-Core 7.0, has a new approach to USCDI requirements.
    • As noted in the US Core 7.0 Must Support section, US Core 7.0 no longer highlights mandatory (cardinality 1..* or 1..1) and Must Support elements with a (USCDI) indicator as such items must be supported for interoperability.
    • Those USCDI elements that are not mandatory or Must Support now include an indicator (ADDITIONAL USCDI) in US Core. QI-Core 7.0 does not reference USCDI elements; rather, users should access US Core 7.0 to understand its implementation of USCDI version 4.
  • We invite comments about the approach and suggestions for other options that would also avoid unnecessary noise or reading load to the QI-Core profile representation.
  • Further, QI-Core 7.0 does not discuss USCDI+Quality because at the time of ballot preparation, no published version of USCDI+Quality is available. We seek reviewer advice regarding how QI-Core might address future USCDI+Quality.

Usage

See the patterns page for implementation and usage patterns.

To create an expression specifically requesting information that a communication intentionally did not occur for a medical, patient or system reason, use the profile QICore-communicationnotdone.

The Communication and CommunicationNotDone profiles represent the positive and negative statements for a communication event. To ensure instances retrieved meet positive intent, applications should check the status as illustrated in this example:

define Communication:
  [Communication] C
    where C.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }

Examples

Written Alert Example

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 0..* Communication A record of information transmitted from a sender to a receiver
... status 1..1 code (QI) preparation | in-progress | on-hold | stopped | completed | entered-in-error | unknown
Binding: Non-Negative Event Status (required)
... subject 0..1 Reference(QICore Patient | Group) (QI) Focus of message
... topic 0..1 CodeableConcept (QI) Description of the purpose/content
Binding: CommunicationTopic (preferred)
... received 0..1 dateTime (QI) When received
... recipient 0..* Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson | Group) (QI) Message recipient
... sender 0..1 Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Message sender

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Communication.statusrequiredNonNegativeEventStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-event-status
from this IG
Communication.topicpreferredCommunicationTopic
http://terminology.hl7.org/ValueSet/communication-topic
NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication 0..* Communication A record of information transmitted from a sender to a receiver
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code (QI) preparation | in-progress | on-hold | stopped | completed | entered-in-error | unknown
Binding: Non-Negative Event Status (required)
... topic 0..1 CodeableConcept (QI) Description of the purpose/content
Binding: CommunicationTopic (preferred)
... sent 0..1 dateTime (QI) When sent
... received 0..1 dateTime (QI) When received
... recipient 0..* Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson | Group) (QI) Message recipient
... sender 0..1 Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Message sender

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Communication.statusrequiredNonNegativeEventStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-event-status
from this IG
Communication.topicpreferredCommunicationTopic
http://terminology.hl7.org/ValueSet/communication-topic

Constraints

IdGradePath(s)DetailsRequirements
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 0..* Communication A record of information transmitted from a sender to a receiver
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Unique identifier
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(Resource) Request fulfilled by this communication
... partOf Σ 0..* Reference(Resource) Part of this action
... inResponseTo 0..* Reference(Communication) Reply to
... status ?!Σ 1..1 code (QI) preparation | in-progress | on-hold | stopped | completed | entered-in-error | unknown
Binding: Non-Negative Event Status (required)
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.

... category 0..* CodeableConcept Message category
Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Codes indicating the relative importance of a communication.

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


... subject Σ 0..1 Reference(QICore Patient | Group) (QI) Focus of message
... topic 0..1 CodeableConcept (QI) Description of the purpose/content
Binding: CommunicationTopic (preferred)
... about 0..* Reference(Resource) Resources that pertain to this communication
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... sent 0..1 dateTime (QI) When sent
... received 0..1 dateTime (QI) When received
... recipient 0..* Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson | Group) (QI) Message recipient
... sender 0..1 Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Message sender
... reasonCode Σ 0..* CodeableConcept Indication for message
Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.


... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why was communication done?
... payload 0..* BackboneElement Message payload
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... content[x] 1..1 Message part content
..... contentString string
..... contentAttachment Attachment
..... contentReference Reference(Resource)
... note 0..* Annotation Comments made about the communication

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Communication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Communication.statusrequiredNonNegativeEventStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-event-status
from this IG
Communication.statusReasonexampleCommunicationNotDoneReason
http://hl7.org/fhir/ValueSet/communication-not-done-reason
from the FHIR Standard
Communication.categoryexampleCommunicationCategory
http://hl7.org/fhir/ValueSet/communication-category
from the FHIR Standard
Communication.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
Communication.mediumexampleParticipationMode
http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.topicpreferredCommunicationTopic
http://terminology.hl7.org/ValueSet/communication-topic
Communication.reasonCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
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()

Differential View

This structure is derived from Communication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication 0..* Communication A record of information transmitted from a sender to a receiver
... status 1..1 code (QI) preparation | in-progress | on-hold | stopped | completed | entered-in-error | unknown
Binding: Non-Negative Event Status (required)
... subject 0..1 Reference(QICore Patient | Group) (QI) Focus of message
... topic 0..1 CodeableConcept (QI) Description of the purpose/content
Binding: CommunicationTopic (preferred)
... received 0..1 dateTime (QI) When received
... recipient 0..* Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson | Group) (QI) Message recipient
... sender 0..1 Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Message sender

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Communication.statusrequiredNonNegativeEventStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-event-status
from this IG
Communication.topicpreferredCommunicationTopic
http://terminology.hl7.org/ValueSet/communication-topic

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication 0..* Communication A record of information transmitted from a sender to a receiver
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code (QI) preparation | in-progress | on-hold | stopped | completed | entered-in-error | unknown
Binding: Non-Negative Event Status (required)
... topic 0..1 CodeableConcept (QI) Description of the purpose/content
Binding: CommunicationTopic (preferred)
... sent 0..1 dateTime (QI) When sent
... received 0..1 dateTime (QI) When received
... recipient 0..* Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson | Group) (QI) Message recipient
... sender 0..1 Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Message sender

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Communication.statusrequiredNonNegativeEventStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-event-status
from this IG
Communication.topicpreferredCommunicationTopic
http://terminology.hl7.org/ValueSet/communication-topic

Constraints

IdGradePath(s)DetailsRequirements
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 0..* Communication A record of information transmitted from a sender to a receiver
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Unique identifier
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(Resource) Request fulfilled by this communication
... partOf Σ 0..* Reference(Resource) Part of this action
... inResponseTo 0..* Reference(Communication) Reply to
... status ?!Σ 1..1 code (QI) preparation | in-progress | on-hold | stopped | completed | entered-in-error | unknown
Binding: Non-Negative Event Status (required)
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.

... category 0..* CodeableConcept Message category
Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Codes indicating the relative importance of a communication.

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


... subject Σ 0..1 Reference(QICore Patient | Group) (QI) Focus of message
... topic 0..1 CodeableConcept (QI) Description of the purpose/content
Binding: CommunicationTopic (preferred)
... about 0..* Reference(Resource) Resources that pertain to this communication
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... sent 0..1 dateTime (QI) When sent
... received 0..1 dateTime (QI) When received
... recipient 0..* Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson | Group) (QI) Message recipient
... sender 0..1 Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson) (QI) Message sender
... reasonCode Σ 0..* CodeableConcept Indication for message
Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.


... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why was communication done?
... payload 0..* BackboneElement Message payload
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... content[x] 1..1 Message part content
..... contentString string
..... contentAttachment Attachment
..... contentReference Reference(Resource)
... note 0..* Annotation Comments made about the communication

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Communication.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Communication.statusrequiredNonNegativeEventStatus
http://hl7.org/fhir/us/qicore/ValueSet/qicore-non-negative-event-status
from this IG
Communication.statusReasonexampleCommunicationNotDoneReason
http://hl7.org/fhir/ValueSet/communication-not-done-reason
from the FHIR Standard
Communication.categoryexampleCommunicationCategory
http://hl7.org/fhir/ValueSet/communication-category
from the FHIR Standard
Communication.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
Communication.mediumexampleParticipationMode
http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.topicpreferredCommunicationTopic
http://terminology.hl7.org/ValueSet/communication-topic
Communication.reasonCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
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()

 

Other representations of profile: CSV, Excel, Schematron