QI-Core Implementation Guide
4.1.1 - STU 4.1.1 US

This page is part of the Quality Improvement Core Framework (v4.1.1: STU 4) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: QICoreCommunicationNotDone

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone Version: 4.1.1
Draft as of 2018-08-22 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. To ensure instances retrieved meet negative intent, applications should check the status as illustrated in this example:

define CommunicationNotDone:
  [Communication] C
    where C.status = 'not-done'

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:

["Communication": "Macular edema absent (finding)"] MacularEdemaAbsentNotCommunicated
    with "Diabetic Retinopathy Encounter" EncounterDiabeticRetinopathy
      such that MacularEdemaAbsentNotCommunicated.sent during EncounterDiabeticRetinopathy.period
    where MacularEdembaAbsentNotCommunicated.status = 'not-done'
      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

Summary

Mandatory: 4 elements
Must-Support: 5 elements
Fixed Value: 1 element

Extensions

This structure refers to these extensions:

This structure is derived from Communication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication I0..*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 reasonCode or a notDoneValueSet extension shall be provided
... qicore-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: Negation Reason Codes (extensible)
.... qicore-notDoneValueSet SI0..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
NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication I0..*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 reasonCode or a notDoneValueSet extension shall be provided
... id Σ0..1stringLogical 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)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... qicore-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: 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 Σ0..1Reference(Patient | Group)Focus of message
... topic 0..1CodeableConceptDescription of the purpose/content
Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.

... 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 SΣI1..1CodeableConceptIndication for message
Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.


.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... qicore-notDoneValueSet SI0..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
... 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
NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication I0..*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 reasonCode or a notDoneValueSet extension shall be provided
... qicore-recorded 1..1dateTimeExtension
URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-recorded
... status ?!Σ1..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 Σ1..1CodeableConceptReason for current status
Binding: Negation Reason Codes (extensible)
.... qicore-notDoneValueSet I0..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

This structure is derived from Communication

Summary

Mandatory: 4 elements
Must-Support: 5 elements
Fixed Value: 1 element

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from Communication

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication I0..*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 reasonCode or a notDoneValueSet extension shall be provided
... qicore-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: Negation Reason Codes (extensible)
.... qicore-notDoneValueSet SI0..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

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Communication I0..*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 reasonCode or a notDoneValueSet extension shall be provided
... id Σ0..1stringLogical 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)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... qicore-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: 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 Σ0..1Reference(Patient | Group)Focus of message
... topic 0..1CodeableConceptDescription of the purpose/content
Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.

... 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 SΣI1..1CodeableConceptIndication for message
Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.


.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... qicore-notDoneValueSet SI0..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
... 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

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

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

Constraints

IdGradePathDetailsRequirements
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()
cnd-1errorCommunicationto indicate what communication was not carried out, either at least one coding in the reasonCode or a notDoneValueSet extension shall be provided
: reasonCode.extension("http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet").exists() xor reasonCode.coding.exists()
ele-1errorCommunication.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCommunication.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCommunication.extension:recordedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCommunication.extension:recordedMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCommunication.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCommunication.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCommunication.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.instantiatesCanonicalAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.instantiatesUriAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.basedOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.partOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.inResponseToAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.statusReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.priorityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.mediumAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.topicAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.aboutAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.sentAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.receivedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.recipientAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.senderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.reasonCodeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.reasonCode.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCommunication.reasonCode.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCommunication.reasonCode.extension:notDoneValueSetAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCommunication.reasonCode.extension:notDoneValueSetMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCommunication.reasonCode.codingAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.reasonCode.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.reasonReferenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.payloadAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.payload.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCommunication.payload.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCommunication.payload.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorCommunication.payload.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorCommunication.payload.content[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorCommunication.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())