QI-Core Implementation Guide
7.0.0 - STU 7 United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0: STU7 (v7.0.0)) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. 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: 7.0.0
Standards status: Trial-use Maturity Level: 4 Computable Name: QICoreCommunicationNotDone

Negation profile of Communication for decision support/quality metrics. Indicates that the communication was not performed for a reason.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
QI Elements:
  • extension(event-recorded): (QI) Captures the recorded date of the communication
  • topic.extension(codeOptions): (QI) Url of a value set of candidate topics
  • statusReason: (QI) Reason for current status
  • sender: (QI) Message sender
  • sent: (QI) When sent
  • topic: (QI) Description of the purpose/content
  • subject: (QI) Focus of message
  • received: (QI) When received
  • status: (QI) not-done
  • recipient: (QI) Message recipient
Primary code path: topic
(PCPath) This element is the primary code path for this resource CQL Retrieve

Usage

The Communication profile defines the conformance expectations for a Communication event, regardless of whether it is a positive or negative statement.

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

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

define "Medication Not Available":
["CommunicationNotDone": "progress update"] ProgressUpdate
    where ProgressUpdate.topic = 'progress-update'
    and ProgressUpdate.status = 'completed'
    and ProgressUpdate.reasonCode = 'Medication not available from manufacturer (finding)'
        )

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

See the patterns page for implementation and usage patterns.

Examples

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

Usages:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication C 0..* QICoreCommunication A record of information transmitted from a sender to a receiver
Constraints: com-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:event-recorded 1..1 dateTime (QI) Captures the recorded date of the communication
URL: http://hl7.org/fhir/StructureDefinition/event-recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... statusReason Σ 1..1 CodeableConcept (QI) Reason for current status
Binding: QICore Negation Reason Codes (extensible)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Communication.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/event-status|4.0.1
From the FHIR Standard
Communication.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
From this IG

Constraints

IdGradePath(s)DetailsRequirements
com-1errorCommunicationto indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided
: topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.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()

This structure is derived from QICoreCommunication

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication 0..* QICoreCommunication A record of information transmitted from a sender to a receiver
... Slices for extension Content/Rules for all slices
.... extension:event-recorded 1..1 dateTime (QI) Captures the recorded date of the communication
URL: http://hl7.org/fhir/StructureDefinition/event-recorded
... status 1..1 code (QI) not-done
Fixed Value: not-done
... statusReason 1..1 CodeableConcept (QI) Reason for current status
Binding: QICore Negation Reason Codes (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Communication.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
From this IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication C 0..* QICoreCommunication A record of information transmitted from a sender to a receiver
Constraints: com-1
... 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
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:event-recorded 1..1 dateTime (QI) Captures the recorded date of the communication
URL: http://hl7.org/fhir/StructureDefinition/event-recorded
... 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) not-done
Binding: EventStatus (required): The status of the communication.
Fixed Value: not-done
... statusReason Σ 1..1 CodeableConcept (QI) Reason for current status
Binding: QICore Negation Reason Codes (extensible)
... 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 C 0..1 CodeableConcept (QI) Description of the purpose/content
Binding: CommunicationTopic (1.0.0) (preferred)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate topics
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... 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 CareTeam | 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

PathConformanceValueSet / CodeURI
Communication.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Communication.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/event-status|4.0.1
From the FHIR Standard
Communication.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
From this IG
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|1.0.0
Communication.reasonCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
From the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
com-1errorCommunicationto indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided
: topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.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()

This structure is derived from QICoreCommunication

Summary

Mandatory: 3 elements
Fixed: 1 element

Extensions

This structure refers to these extensions:

Maturity: 4

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication C 0..* QICoreCommunication A record of information transmitted from a sender to a receiver
Constraints: com-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:event-recorded 1..1 dateTime (QI) Captures the recorded date of the communication
URL: http://hl7.org/fhir/StructureDefinition/event-recorded
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... statusReason Σ 1..1 CodeableConcept (QI) Reason for current status
Binding: QICore Negation Reason Codes (extensible)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Communication.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/event-status|4.0.1
From the FHIR Standard
Communication.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
From this IG

Constraints

IdGradePath(s)DetailsRequirements
com-1errorCommunicationto indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided
: topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.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()

Differential View

This structure is derived from QICoreCommunication

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication 0..* QICoreCommunication A record of information transmitted from a sender to a receiver
... Slices for extension Content/Rules for all slices
.... extension:event-recorded 1..1 dateTime (QI) Captures the recorded date of the communication
URL: http://hl7.org/fhir/StructureDefinition/event-recorded
... status 1..1 code (QI) not-done
Fixed Value: not-done
... statusReason 1..1 CodeableConcept (QI) Reason for current status
Binding: QICore Negation Reason Codes (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Communication.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
From this IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication C 0..* QICoreCommunication A record of information transmitted from a sender to a receiver
Constraints: com-1
... 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
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:event-recorded 1..1 dateTime (QI) Captures the recorded date of the communication
URL: http://hl7.org/fhir/StructureDefinition/event-recorded
... 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) not-done
Binding: EventStatus (required): The status of the communication.
Fixed Value: not-done
... statusReason Σ 1..1 CodeableConcept (QI) Reason for current status
Binding: QICore Negation Reason Codes (extensible)
... 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 C 0..1 CodeableConcept (QI) Description of the purpose/content
Binding: CommunicationTopic (1.0.0) (preferred)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:codeOptions C 0..1 canonical(ValueSet) (QI) Url of a value set of candidate topics
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... 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 CareTeam | 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

PathConformanceValueSet / CodeURI
Communication.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Communication.statusrequiredFixed Value: not-done
http://hl7.org/fhir/ValueSet/event-status|4.0.1
From the FHIR Standard
Communication.statusReasonextensibleNegationReasonCodes
http://hl7.org/fhir/us/qicore/ValueSet/qicore-negation-reason
From this IG
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|1.0.0
Communication.reasonCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
From the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
com-1errorCommunicationto indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided
: topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.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()

This structure is derived from QICoreCommunication

Summary

Mandatory: 3 elements
Fixed: 1 element

Extensions

This structure refers to these extensions:

Maturity: 4

 

Other representations of profile: CSV, Excel, Schematron