An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency was notified about a reportable condition.

Local id of this artifact.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

The base language in which the resource is written.

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).

A human-readable narrative that contains a summary of the resource, and may 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.

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 in formation is added later.

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.

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.

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

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.

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. Usually modifier elements provide negation or qualification. In order 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.

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.

Identifiers associated with this Communication that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

A protocol, guideline, or other definition that was adhered to in whole or in part by this communication event.

An order, proposal or plan fulfilled in whole or in part by this Communication.

This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ReferralRequest, MedicationRequest, etc.

Part of this action.

The status of the transmission.

This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.

If true, indicates that the described communication event did not actually occur.

Creating a Communication where notDone is true is intended for situations where there's a need for a specific statement in the record about something not being done. If the need is merely to indicate that a request wasn't fulfilled, that should be handled using Task.

This element is labeled as a modifier because it marks the communication as a communication that did not occur. The more attributes are populated, the more constrained the negated statement is.

Describes why the communication event did not occur in coded and/or textual form.

The type of message conveyed such as alert, notification, reminder, instruction, etc.

There may be multiple axes of categorization and one communication may serve multiple purposes.

A channel that was used for this communication (e.g. email, fax).

The patient or group that was the focus of this communication.

The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time).

The resources which were responsible for or related to producing this communication.

The encounter within which the communication was sent.

The time when this communication was sent.

The time when this communication arrived at the destination.

The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

The reason or justification for the communication.

Textual reasons can be caprued using reasonCode.text.

Indicates another resource whose existence justifies this communication.

Text, attachment(s), or resource(s) that was communicated to the recipient.

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

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.

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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

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.

A communicated content (or for multi-part communications, one portion of the communication).

Additional notes or commentary about the communication by the sender, receiver or other interested parties.