Extensions for Using Data Elements from FHIR STU3 in FHIR R4B
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Extensions for Using Data Elements from FHIR STU3 in FHIR R4B - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R3_Consent_R4B - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the profile-Consent resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Consent
Definition

A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.

ShortA healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
Comments

Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.

Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
2. Consent.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Consent.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Consent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Consent.extension:period
    Slice Nameperiod
    Definition

    STU3: Consent.period (new:Period)

    ShortSTU3: Period that this consent applies (new)
    Comments

    Element Consent.period has a context of Consent based on following the parent source element upwards and mapping to Consent. Element Consent.period has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). This can be a subset of the period of the original statement.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(STU3: Period that this consent applies (new)) (Extension Type: Period)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Consent.extension:source
    Slice Namesource
    Definition

    STU3: Consent.source[x] additional types (Attachment, Identifier)

    ShortSTU3: source additional types
    Comments

    Element Consent.source[x] is mapped to FHIR R4B element Consent.source[x] as SourceIsBroaderThanTarget. The mappings for Consent.source[x] do not cover the following types: Attachment, Identifier. The target context Consent.source[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Consent. The standard extension alternate-reference has been mapped as PART of the representation of FHIR STU3 element Consent.source[x] with unmapped reference targets: Consent, Contract, DocumentReference, QuestionnaireResponse. Source element Consent.source[x] has unmapped reference types. While the target element Consent.source[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(STU3: source additional types) (Extension Type: Choice of: Attachment, Identifier)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Consent.modifierExtension
    Definition

    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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Consent.status
    Definition

    Indicates the current state of this consent.

    Shortdraft | proposed | active | rejected | inactive | entered-in-error
    Comments

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

    Control1..1
    BindingThe codes SHALL be taken from ConsentStatehttp://hl7.org/fhir/ValueSet/consent-state-codes|4.3.0
    (required to http://hl7.org/fhir/ValueSet/consent-state-codes|4.3.0)

    Indicates the state of the consent.

    Typecode
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Requirements

    The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Consent.scope
    Definition

    A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible.

    ShortWhich of the four areas this resource covers (extensible)
    Control1..1
    BindingUnless not suitable, these codes SHALL be taken from ConsentScopeCodeshttp://hl7.org/fhir/ValueSet/consent-scope|4.3.0
    (extensible to http://hl7.org/fhir/ValueSet/consent-scope|4.3.0)

    The four anticipated uses for the Consent Resource.

    TypeCodeableConcept
    Is Modifiertrue because Allows changes to codes based on scope selection
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Consent.category
    Definition

    A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.

    ShortClassification of the consent statement - for indexing/retrieval
    Control1..*
    BindingUnless not suitable, these codes SHALL be taken from ConsentCategoryCodeshttp://hl7.org/fhir/ValueSet/consent-category|4.3.0
    (extensible to http://hl7.org/fhir/ValueSet/consent-category|4.3.0)

    A classification of the type of consents found in a consent statement.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. Consent
    2. Consent.meta
    4. Consent.meta.extension
    Control0..*
    SlicingThis element introduces a set of slices on Consent.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. Consent.meta.extension:meta
      Slice Namemeta
      Definition

      STU3: Consent.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

      ShortSTU3: meta additional types
      Comments

      Element Consent.meta is mapped to FHIR R4B element Consent.meta as SourceIsBroaderThanTarget. The mappings for Consent.meta do not cover the following types: Meta. The mappings for Consent.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

      Control0..1
      TypeExtension(STU3: meta additional types) (Complex Extension)
      8. Consent.text
      10. Consent.text.extension
      Control0..*
      SlicingThis element introduces a set of slices on Consent.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 12. Consent.text.extension:text
        Slice Nametext
        Definition

        STU3: Consent.text additional types (Narrative) additional types from child elements (div, status)

        ShortSTU3: text additional types
        Comments

        Element Consent.text is mapped to FHIR R4B element Consent.text as SourceIsBroaderThanTarget. The mappings for Consent.text do not cover the following types: Narrative. The mappings for Consent.text do not cover the following types based on type expansion: div, status. 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.

        Control0..1
        TypeExtension(STU3: text additional types) (Complex Extension)
        14. Consent.extension
        Control0..*
        SlicingThis element introduces a set of slices on Consent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. Consent.extension:period
          Slice Nameperiod
          Definition

          STU3: Consent.period (new:Period)

          ShortSTU3: Period that this consent applies (new)
          Comments

          Element Consent.period has a context of Consent based on following the parent source element upwards and mapping to Consent. Element Consent.period has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). This can be a subset of the period of the original statement.

          Control0..1
          TypeExtension(STU3: Period that this consent applies (new)) (Extension Type: Period)
          18. Consent.extension:source
          Slice Namesource
          Definition

          STU3: Consent.source[x] additional types (Attachment, Identifier)

          ShortSTU3: source additional types
          Comments

          Element Consent.source[x] is mapped to FHIR R4B element Consent.source[x] as SourceIsBroaderThanTarget. The mappings for Consent.source[x] do not cover the following types: Attachment, Identifier. The target context Consent.source[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Consent. The standard extension alternate-reference has been mapped as PART of the representation of FHIR STU3 element Consent.source[x] with unmapped reference targets: Consent, Contract, DocumentReference, QuestionnaireResponse. Source element Consent.source[x] has unmapped reference types. While the target element Consent.source[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

          Control0..1
          TypeExtension(STU3: source additional types) (Extension Type: Choice of: Attachment, Identifier)
          20. Consent.identifier
          NoteThis is a business identifier, not a resource identifier (see discussion)
          22. Consent.identifier.extension
          Control0..*
          SlicingThis element introduces a set of slices on Consent.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 24. Consent.identifier.extension:identifier
            Slice Nameidentifier
            Definition

            STU3: Consent.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

            ShortSTU3: identifier additional types
            Comments

            Element Consent.identifier is mapped to FHIR R4B element Consent.identifier as RelatedTo. The mappings for Consent.identifier do not cover the following types: Identifier. The mappings for Consent.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value. This identifier is identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.

            Control0..1
            TypeExtension(STU3: identifier additional types) (Extension Type: Identifier)
            26. Consent.patient
            28. Consent.patient.extension
            Control1..*
            SlicingThis element introduces a set of slices on Consent.patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 30. Consent.patient.extension:patient
              Slice Namepatient
              Definition

              STU3: Consent.patient additional types from child elements (display, identifier, reference)

              ShortSTU3: patient additional types
              Comments

              Element Consent.patient is mapped to FHIR R4B element Consent.patient as SourceIsBroaderThanTarget. The mappings for Consent.patient do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.patient with unmapped reference targets: Patient. Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

              Control1..1
              TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
              32. Consent.performer
              34. Consent.performer.extension
              Control0..*
              SlicingThis element introduces a set of slices on Consent.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 36. Consent.performer.extension:consentingParty
                Slice NameconsentingParty
                Definition

                STU3: Consent.consentingParty

                ShortSTU3: Who is agreeing to the policy and exceptions
                Comments

                Element Consent.consentingParty is mapped to FHIR R4B element Consent.performer as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.consentingParty with unmapped reference targets: Organization, Patient, Practitioner, RelatedPerson. Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.

                Control0..*
                TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                38. Consent.organization
                40. Consent.organization.extension
                Control0..*
                SlicingThis element introduces a set of slices on Consent.organization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 42. Consent.organization.extension:organization
                  Slice Nameorganization
                  Definition

                  STU3: Consent.organization additional types from child elements (display, identifier, reference)

                  ShortSTU3: organization additional types
                  Comments

                  Element Consent.organization is mapped to FHIR R4B element Consent.organization as SourceIsBroaderThanTarget. The mappings for Consent.organization do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.organization with unmapped reference targets: Organization.

                  Control0..*
                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                  44. Consent.sourceReference
                  46. Consent.sourceReference.extension:alternateReference
                  Slice NamealternateReference
                  Definition

                  STU3: Consent.source[x] additional types (Attachment, Identifier)

                  ShortSTU3: source additional types
                  Comments

                  Element Consent.source[x] is mapped to FHIR R4B element Consent.source[x] as SourceIsBroaderThanTarget. The mappings for Consent.source[x] do not cover the following types: Attachment, Identifier. The target context Consent.source[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Consent. The standard extension alternate-reference has been mapped as PART of the representation of FHIR STU3 element Consent.source[x] with unmapped reference targets: Consent, Contract, DocumentReference, QuestionnaireResponse. Source element Consent.source[x] has unmapped reference types. While the target element Consent.source[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                  48. Consent.policyRule
                  50. Consent.policyRule.extension
                  Control0..*
                  SlicingThis element introduces a set of slices on Consent.policyRule.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 52. Consent.policyRule.extension:policyRule
                    Slice NamepolicyRule
                    Definition

                    STU3: Consent.policyRule additional types (uri) additional types from child elements (value)

                    ShortSTU3: Policy that this consents to additional types
                    Comments

                    Element Consent.policyRule is mapped to FHIR R4B element Consent.policyRule as SourceIsBroaderThanTarget. The mappings for Consent.policyRule do not cover the following types: uri. The mappings for Consent.policyRule do not cover the following types based on type expansion: value. If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.

                    Control0..1
                    TypeExtension(STU3: Policy that this consents to additional types) (Extension Type: uri)
                    54. Consent.provision
                    56. Consent.provision.period
                    58. Consent.provision.period.extension
                    Control0..*
                    SlicingThis element introduces a set of slices on Consent.provision.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 60. Consent.provision.period.extension:period
                      Slice Nameperiod
                      Definition

                      STU3: Consent.except.period additional types (Period) additional types from child elements (end, start)

                      ShortSTU3: Timeframe for this exception additional types
                      Comments

                      Element Consent.except.period is mapped to FHIR R4B element Consent.provision.period as SourceIsBroaderThanTarget. The mappings for Consent.except.period do not cover the following types: Period. The mappings for Consent.except.period do not cover the following types based on type expansion: end, start.

                      Control0..1
                      TypeExtension(STU3: Timeframe for this exception additional types) (Extension Type: Period)
                      62. Consent.provision.actor
                      64. Consent.provision.actor.reference
                      66. Consent.provision.actor.reference.extension
                      Control0..*
                      SlicingThis element introduces a set of slices on Consent.provision.actor.reference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 68. Consent.provision.actor.reference.extension:reference
                        Slice Namereference
                        Definition

                        STU3: Consent.actor.reference

                        ShortSTU3: reference
                        Comments

                        Element Consent.actor.reference is mapped to FHIR R4B element Consent.provision.actor.reference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.actor.reference with unmapped reference targets: CareTeam, Device, Group, Organization, Patient, Practitioner, RelatedPerson.

                        Control0..1
                        TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                        70. Consent.provision.actor.reference.extension:reference
                        Slice Namereference
                        Definition

                        STU3: Consent.except.actor.reference

                        ShortSTU3: reference
                        Comments

                        Element Consent.except.actor.reference is mapped to FHIR R4B element Consent.provision.actor.reference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.except.actor.reference with unmapped reference targets: CareTeam, Device, Group, Organization, Patient, Practitioner, RelatedPerson.

                        Control0..1
                        TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                        72. Consent.provision.dataPeriod
                        74. Consent.provision.dataPeriod.extension
                        Control0..*
                        SlicingThis element introduces a set of slices on Consent.provision.dataPeriod.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 76. Consent.provision.dataPeriod.extension:dataPeriod
                          Slice NamedataPeriod
                          Definition

                          STU3: Consent.dataPeriod additional types (Period) additional types from child elements (end, start)

                          ShortSTU3: Timeframe for data controlled by this consent additional types
                          Comments

                          Element Consent.dataPeriod is mapped to FHIR R4B element Consent.provision.dataPeriod as SourceIsBroaderThanTarget. The mappings for Consent.dataPeriod do not cover the following types: Period. The mappings for Consent.dataPeriod do not cover the following types based on type expansion: end, start. This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

                          Control0..1
                          TypeExtension(STU3: Timeframe for data controlled by this consent additional types) (Extension Type: Period)
                          78. Consent.provision.dataPeriod.extension:dataPeriod
                          Slice NamedataPeriod
                          Definition

                          STU3: Consent.except.dataPeriod additional types (Period) additional types from child elements (end, start)

                          ShortSTU3: Timeframe for data controlled by this exception additional types
                          Comments

                          Element Consent.except.dataPeriod is mapped to FHIR R4B element Consent.provision.dataPeriod as SourceIsBroaderThanTarget. The mappings for Consent.except.dataPeriod do not cover the following types: Period. The mappings for Consent.except.dataPeriod do not cover the following types based on type expansion: end, start. This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

                          Control0..1
                          TypeExtension(STU3: Timeframe for data controlled by this exception additional types) (Extension Type: Period)
                          80. Consent.provision.data
                          82. Consent.provision.data.reference
                          84. Consent.provision.data.reference.extension
                          Control0..*
                          SlicingThis element introduces a set of slices on Consent.provision.data.reference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 86. Consent.provision.data.reference.extension:reference
                            Slice Namereference
                            Definition

                            STU3: Consent.data.reference additional types from child elements (display, identifier, reference)

                            ShortSTU3: reference additional types
                            Comments

                            Element Consent.data.reference is mapped to FHIR R4B element Consent.provision.data.reference as SourceIsBroaderThanTarget. The mappings for Consent.data.reference do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.data.reference with unmapped reference targets: Resource.

                            Control0..1
                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                            88. Consent.provision.data.reference.extension:reference
                            Slice Namereference
                            Definition

                            STU3: Consent.except.data.reference additional types from child elements (display, identifier, reference)

                            ShortSTU3: reference additional types
                            Comments

                            Element Consent.except.data.reference is mapped to FHIR R4B element Consent.provision.data.reference as SourceIsBroaderThanTarget. The mappings for Consent.except.data.reference do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.except.data.reference with unmapped reference targets: Resource.

                            Control0..1
                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))

                            Guidance on how to interpret the contents of this table can be foundhere

                            0. Consent
                            Definition

                            A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.

                            ShortA healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
                            Comments

                            Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.

                            Control0..*
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                            dom-3: If 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty())
                            dom-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                            dom-6: A resource should have narrative for robust management (text.`div`.exists())
                            ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
                            ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
                            ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
                            ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
                            ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
                            2. Consent.id
                            Definition

                            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                            ShortLogical id of this artifact
                            Comments

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

                            Control0..1
                            Typeid
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            4. Consent.meta
                            Definition

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

                            ShortMetadata about the resource
                            Control0..1
                            TypeMeta
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            6. Consent.meta.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typeid
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            8. Consent.meta.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Consent.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 10. Consent.meta.extension:meta
                              Slice Namemeta
                              Definition

                              STU3: Consent.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, tag, versionId)

                              ShortSTU3: meta additional types
                              Comments

                              Element Consent.meta is mapped to FHIR R4B element Consent.meta as SourceIsBroaderThanTarget. The mappings for Consent.meta do not cover the following types: Meta. The mappings for Consent.meta do not cover the following types based on type expansion: lastUpdated, profile, security, tag, versionId.

                              Control0..1
                              TypeExtension(STU3: meta additional types) (Complex Extension)
                              Is Modifierfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              12. Consent.meta.versionId
                              Definition

                              The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                              ShortVersion specific identifier
                              Comments

                              The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                              Control0..1
                              Typeid
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              14. Consent.meta.lastUpdated
                              Definition

                              When the resource last changed - e.g. when the version changed.

                              ShortWhen the resource version last changed
                              Comments

                              This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                              Control0..1
                              Typeinstant
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              16. Consent.meta.source
                              Definition

                              A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                              ShortIdentifies where the resource comes from
                              Comments

                              In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                              This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                              Control0..1
                              Typeuri
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              18. Consent.meta.profile
                              Definition

                              A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                              ShortProfiles this resource claims to conform to
                              Comments

                              It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                              Control0..*
                              Typecanonical(StructureDefinition)
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              20. Consent.meta.security
                              Definition

                              Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                              ShortSecurity Labels applied to this resource
                              Comments

                              The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                              Control0..*
                              BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                              (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.3.0)
                              TypeCoding
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              22. Consent.meta.tag
                              Definition

                              Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                              ShortTags applied to this resource
                              Comments

                              The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                              Control0..*
                              BindingFor example codes, see CommonTags
                              (example to http://hl7.org/fhir/ValueSet/common-tags|4.3.0)
                              TypeCoding
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              24. Consent.implicitRules
                              Definition

                              A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                              ShortA set of rules under which this content was created
                              Comments

                              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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                              Control0..1
                              Typeuri
                              Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              26. Consent.language
                              Definition

                              The base language in which the resource is written.

                              ShortLanguage of the resource content
                              Comments

                              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).

                              Control0..1
                              BindingThe codes SHOULD be taken from CommonLanguages
                              (preferred to http://hl7.org/fhir/ValueSet/languages|4.3.0)

                              IETF language tag

                              Additional BindingsPurpose
                              AllLanguagesMax Binding
                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              28. Consent.text
                              Definition

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

                              ShortText summary of the resource, for human interpretation
                              Comments

                              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 information is added later.

                              Control0..1
                              TypeNarrative
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Alternate Namesnarrative, html, xhtml, display
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              30. Consent.text.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              Typeid
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              32. Consent.text.extension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingThis element introduces a set of slices on Consent.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 34. Consent.text.extension:text
                                Slice Nametext
                                Definition

                                STU3: Consent.text additional types (Narrative) additional types from child elements (div, status)

                                ShortSTU3: text additional types
                                Comments

                                Element Consent.text is mapped to FHIR R4B element Consent.text as SourceIsBroaderThanTarget. The mappings for Consent.text do not cover the following types: Narrative. The mappings for Consent.text do not cover the following types based on type expansion: div, status. 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.

                                Control0..1
                                TypeExtension(STU3: text additional types) (Complex Extension)
                                Is Modifierfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                36. Consent.text.status
                                Definition

                                The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

                                Shortgenerated | extensions | additional | empty
                                Control1..1
                                BindingThe codes SHALL be taken from NarrativeStatus
                                (required to http://hl7.org/fhir/ValueSet/narrative-status|4.3.0)
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                38. Consent.text.div
                                Definition

                                The actual narrative content, a stripped down version of XHTML.

                                ShortLimited xhtml content
                                Comments

                                The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

                                Control1..1
                                Typexhtml
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
                                txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
                                40. Consent.contained
                                Definition

                                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.

                                ShortContained, inline Resources
                                Comments

                                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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                Control0..*
                                TypeResource
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Alternate Namesinline resources, anonymous resources, contained resources
                                Invariantsdom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))
                                42. Consent.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Consent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 44. Consent.extension:period
                                  Slice Nameperiod
                                  Definition

                                  STU3: Consent.period (new:Period)

                                  ShortSTU3: Period that this consent applies (new)
                                  Comments

                                  Element Consent.period has a context of Consent based on following the parent source element upwards and mapping to Consent. Element Consent.period has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element). This can be a subset of the period of the original statement.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(STU3: Period that this consent applies (new)) (Extension Type: Period)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  46. Consent.extension:source
                                  Slice Namesource
                                  Definition

                                  STU3: Consent.source[x] additional types (Attachment, Identifier)

                                  ShortSTU3: source additional types
                                  Comments

                                  Element Consent.source[x] is mapped to FHIR R4B element Consent.source[x] as SourceIsBroaderThanTarget. The mappings for Consent.source[x] do not cover the following types: Attachment, Identifier. The target context Consent.source[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Consent. The standard extension alternate-reference has been mapped as PART of the representation of FHIR STU3 element Consent.source[x] with unmapped reference targets: Consent, Contract, DocumentReference, QuestionnaireResponse. Source element Consent.source[x] has unmapped reference types. While the target element Consent.source[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(STU3: source additional types) (Extension Type: Choice of: Attachment, Identifier)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  48. Consent.modifierExtension
                                  Definition

                                  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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored
                                  Comments

                                  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.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  50. Consent.identifier
                                  Definition

                                  Unique identifier for this copy of the Consent Statement.

                                  ShortIdentifier for this record (external references)
                                  Comments

                                  This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.

                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control0..*
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  52. Consent.identifier.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typeid
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  54. Consent.identifier.extension
                                  Definition

                                  An Extension

                                  ShortExtension
                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Consent.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 56. Consent.identifier.extension:identifier
                                    Slice Nameidentifier
                                    Definition

                                    STU3: Consent.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

                                    ShortSTU3: identifier additional types
                                    Comments

                                    Element Consent.identifier is mapped to FHIR R4B element Consent.identifier as RelatedTo. The mappings for Consent.identifier do not cover the following types: Identifier. The mappings for Consent.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value. This identifier is identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.

                                    Control0..1
                                    TypeExtension(STU3: identifier additional types) (Extension Type: Identifier)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    58. Consent.identifier.use
                                    Definition

                                    The purpose of this identifier.

                                    Shortusual | official | temp | secondary | old (If known)
                                    Comments

                                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                    Control0..1
                                    BindingThe codes SHALL be taken from IdentifierUse
                                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.3.0)
                                    Typecode
                                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    60. Consent.identifier.type
                                    Definition

                                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                    ShortDescription of identifier
                                    Comments

                                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                    Control0..1
                                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type|4.3.0)
                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows users to make use of identifiers when the identifier system is not known.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    62. Consent.identifier.system
                                    Definition

                                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                    ShortThe namespace for the identifier value
                                    Comments

                                    Identifier.system is always case sensitive.

                                    Control0..1
                                    Typeuri
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                    ExampleGeneral: http://www.acme.com/identifiers/patient
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    64. Consent.identifier.value
                                    Definition

                                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                    ShortThe value that is unique
                                    Comments

                                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    ExampleGeneral: 123456
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    66. Consent.identifier.period
                                    Definition

                                    Time period during which identifier is/was valid for use.

                                    ShortTime period when id is/was valid for use
                                    Control0..1
                                    TypePeriod
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    68. Consent.identifier.assigner
                                    Definition

                                    Organization that issued/manages the identifier.

                                    ShortOrganization that issued id (may be just text)
                                    Comments

                                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                    Control0..1
                                    TypeReference(Organization)
                                    Is Modifierfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    70. Consent.status
                                    Definition

                                    Indicates the current state of this consent.

                                    Shortdraft | proposed | active | rejected | inactive | entered-in-error
                                    Comments

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

                                    Control1..1
                                    BindingThe codes SHALL be taken from ConsentState
                                    (required to http://hl7.org/fhir/ValueSet/consent-state-codes|4.3.0)

                                    Indicates the state of the consent.

                                    Typecode
                                    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supportfalse
                                    Summarytrue
                                    Requirements

                                    The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    72. Consent.scope
                                    Definition

                                    A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible.

                                    ShortWhich of the four areas this resource covers (extensible)
                                    Control1..1
                                    BindingUnless not suitable, these codes SHALL be taken from ConsentScopeCodes
                                    (extensible to http://hl7.org/fhir/ValueSet/consent-scope|4.3.0)

                                    The four anticipated uses for the Consent Resource.

                                    TypeCodeableConcept
                                    Is Modifiertrue because Allows changes to codes based on scope selection
                                    Must Supportfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    74. Consent.category
                                    Definition

                                    A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.

                                    ShortClassification of the consent statement - for indexing/retrieval
                                    Control1..*
                                    BindingUnless not suitable, these codes SHALL be taken from ConsentCategoryCodes
                                    (extensible to http://hl7.org/fhir/ValueSet/consent-category|4.3.0)

                                    A classification of the type of consents found in a consent statement.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    76. Consent.patient
                                    Definition

                                    The patient/healthcare consumer to whom this consent applies.

                                    ShortWho the consent applies to
                                    Comments

                                    Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

                                    Control0..1
                                    TypeReference(Patient)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    78. Consent.patient.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typeid
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    80. Consent.patient.extension
                                    Definition

                                    An Extension

                                    ShortExtension
                                    Control1..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Consent.patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 82. Consent.patient.extension:patient
                                      Slice Namepatient
                                      Definition

                                      STU3: Consent.patient additional types from child elements (display, identifier, reference)

                                      ShortSTU3: patient additional types
                                      Comments

                                      Element Consent.patient is mapped to FHIR R4B element Consent.patient as SourceIsBroaderThanTarget. The mappings for Consent.patient do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.patient with unmapped reference targets: Patient. Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

                                      Control1..1
                                      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      84. Consent.patient.reference
                                      Definition

                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                      ShortLiteral reference, Relative, internal or absolute URL
                                      Comments

                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                      Control0..1
                                      This element is affected by the following invariants: ref-1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      86. Consent.patient.type
                                      Definition

                                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                      ShortType the reference refers to (e.g. "Patient")
                                      Comments

                                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                      Control0..1
                                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                      (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                      Typeuri
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      88. Consent.patient.identifier
                                      Definition

                                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                      ShortLogical reference, when literal reference is not known
                                      Comments

                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..1
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      90. Consent.patient.display
                                      Definition

                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                      ShortText alternative for the resource
                                      Comments

                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      92. Consent.dateTime
                                      Definition

                                      When this Consent was issued / created / indexed.

                                      ShortWhen this Consent was created or indexed
                                      Comments

                                      This is not the time of the original consent, but the time that this statement was made or derived.

                                      Control0..1
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      94. Consent.performer
                                      Definition

                                      Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions.

                                      ShortWho is agreeing to the policy and rules
                                      Comments

                                      Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.

                                      Control0..*
                                      TypeReference(Organization, Patient, Practitioner, RelatedPerson, PractitionerRole)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summarytrue
                                      Alternate Namesconsentor
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      96. Consent.performer.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typeid
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      98. Consent.performer.extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Consent.performer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 100. Consent.performer.extension:consentingParty
                                        Slice NameconsentingParty
                                        Definition

                                        STU3: Consent.consentingParty

                                        ShortSTU3: Who is agreeing to the policy and exceptions
                                        Comments

                                        Element Consent.consentingParty is mapped to FHIR R4B element Consent.performer as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.consentingParty with unmapped reference targets: Organization, Patient, Practitioner, RelatedPerson. Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.

                                        Control0..1
                                        TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        102. Consent.performer.reference
                                        Definition

                                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                        ShortLiteral reference, Relative, internal or absolute URL
                                        Comments

                                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                        Control0..1
                                        This element is affected by the following invariants: ref-1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        104. Consent.performer.type
                                        Definition

                                        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                        ShortType the reference refers to (e.g. "Patient")
                                        Comments

                                        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                        Control0..1
                                        BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                        (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                        Typeuri
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        106. Consent.performer.identifier
                                        Definition

                                        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                        ShortLogical reference, when literal reference is not known
                                        Comments

                                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                        Control0..1
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        108. Consent.performer.display
                                        Definition

                                        Plain text narrative that identifies the resource in addition to the resource reference.

                                        ShortText alternative for the resource
                                        Comments

                                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        110. Consent.organization
                                        Definition

                                        The organization that manages the consent, and the framework within which it is executed.

                                        ShortCustodian of the consent
                                        Control0..*
                                        TypeReference(Organization)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summarytrue
                                        Alternate Namescustodian
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        112. Consent.organization.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typeid
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        114. Consent.organization.extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Consent.organization.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 116. Consent.organization.extension:organization
                                          Slice Nameorganization
                                          Definition

                                          STU3: Consent.organization additional types from child elements (display, identifier, reference)

                                          ShortSTU3: organization additional types
                                          Comments

                                          Element Consent.organization is mapped to FHIR R4B element Consent.organization as SourceIsBroaderThanTarget. The mappings for Consent.organization do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.organization with unmapped reference targets: Organization.

                                          Control0..1
                                          TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          118. Consent.organization.reference
                                          Definition

                                          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                          ShortLiteral reference, Relative, internal or absolute URL
                                          Comments

                                          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                          Control0..1
                                          This element is affected by the following invariants: ref-1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          120. Consent.organization.type
                                          Definition

                                          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                          ShortType the reference refers to (e.g. "Patient")
                                          Comments

                                          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                          Control0..1
                                          BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                          (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                          Typeuri
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          122. Consent.organization.identifier
                                          Definition

                                          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                          ShortLogical reference, when literal reference is not known
                                          Comments

                                          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                          Control0..1
                                          TypeIdentifier
                                          Is Modifierfalse
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          124. Consent.organization.display
                                          Definition

                                          Plain text narrative that identifies the resource in addition to the resource reference.

                                          ShortText alternative for the resource
                                          Comments

                                          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          126. Consent.source[x]
                                          Definition

                                          The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document.

                                          ShortSource from which this consent is taken
                                          Comments

                                          The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

                                          Control0..1
                                          TypeChoice of: Attachment, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          128. Consent.source[x].id
                                          Definition

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typeid
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          130. Consent.source[x].extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Consent.source[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 132. Consent.source[x].extension:alternateReference
                                            Slice NamealternateReference
                                            Definition

                                            STU3: Consent.source[x] additional types (Attachment, Identifier)

                                            ShortSTU3: source additional types
                                            Comments

                                            Element Consent.source[x] is mapped to FHIR R4B element Consent.source[x] as SourceIsBroaderThanTarget. The mappings for Consent.source[x] do not cover the following types: Attachment, Identifier. The target context Consent.source[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Consent. The standard extension alternate-reference has been mapped as PART of the representation of FHIR STU3 element Consent.source[x] with unmapped reference targets: Consent, Contract, DocumentReference, QuestionnaireResponse. Source element Consent.source[x] has unmapped reference types. While the target element Consent.source[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

                                            Control0..1
                                            TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            134. Consent.policy
                                            Definition

                                            The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

                                            ShortPolicies covered by this consent
                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                            136. Consent.policy.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            138. Consent.policy.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            140. Consent.policy.modifierExtension
                                            Definition

                                            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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            142. Consent.policy.authority
                                            Definition

                                            Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives.

                                            ShortEnforcement source for policy
                                            Control0..1
                                            This element is affected by the following invariants: ppc-1
                                            Typeuri
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            144. Consent.policy.uri
                                            Definition

                                            The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

                                            ShortSpecific policy covered by this consent
                                            Comments

                                            This element is for discoverability / documentation and does not modify or qualify the policy rules.

                                            Control0..1
                                            This element is affected by the following invariants: ppc-1
                                            Typeuri
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            146. Consent.policyRule
                                            Definition

                                            A reference to the specific base computable regulation or policy.

                                            ShortRegulation that this consents to
                                            Comments

                                            If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource.

                                            Control0..1
                                            This element is affected by the following invariants: ppc-1
                                            BindingUnless not suitable, these codes SHALL be taken from ConsentPolicyRuleCodes
                                            (extensible to http://hl7.org/fhir/ValueSet/consent-policy|4.3.0)

                                            Regulatory policy examples.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summarytrue
                                            Requirements

                                            Might be a unique identifier of a policy set in XACML, or other rules engine.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            148. Consent.policyRule.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typeid
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            150. Consent.policyRule.extension
                                            Definition

                                            An Extension

                                            ShortExtension
                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Consent.policyRule.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 152. Consent.policyRule.extension:policyRule
                                              Slice NamepolicyRule
                                              Definition

                                              STU3: Consent.policyRule additional types (uri) additional types from child elements (value)

                                              ShortSTU3: Policy that this consents to additional types
                                              Comments

                                              Element Consent.policyRule is mapped to FHIR R4B element Consent.policyRule as SourceIsBroaderThanTarget. The mappings for Consent.policyRule do not cover the following types: uri. The mappings for Consent.policyRule do not cover the following types based on type expansion: value. If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.

                                              Control0..1
                                              TypeExtension(STU3: Policy that this consents to additional types) (Extension Type: uri)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              154. Consent.policyRule.coding
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                              Control0..*
                                              TypeCoding
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              156. Consent.policyRule.text
                                              Definition

                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                              ShortPlain text representation of the concept
                                              Comments

                                              Very often the text is the same as a displayName of one of the codings.

                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              158. Consent.verification
                                              Definition

                                              Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person.

                                              ShortConsent Verified by patient or family
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                              160. Consent.verification.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              162. Consent.verification.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              164. Consent.verification.modifierExtension
                                              Definition

                                              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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              166. Consent.verification.verified
                                              Definition

                                              Has the instruction been verified.

                                              ShortHas been verified
                                              Control1..1
                                              Typeboolean
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              168. Consent.verification.verifiedWith
                                              Definition

                                              Who verified the instruction (Patient, Relative or other Authorized Person).

                                              ShortPerson who verified
                                              Control0..1
                                              TypeReference(Patient, RelatedPerson)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              170. Consent.verification.verificationDate
                                              Definition

                                              Date verification was collected.

                                              ShortWhen consent verified
                                              Control0..1
                                              TypedateTime
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              172. Consent.provision
                                              Definition

                                              An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.

                                              ShortConstraints to the base Consent.policyRule
                                              Control0..1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                              174. Consent.provision.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              176. Consent.provision.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              178. Consent.provision.modifierExtension
                                              Definition

                                              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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              180. Consent.provision.type
                                              Definition

                                              Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

                                              Shortdeny | permit
                                              Control0..1
                                              BindingThe codes SHALL be taken from ConsentProvisionType
                                              (required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.3.0)

                                              How a rule statement is applied, such as adding additional consent or removing consent.

                                              Typecode
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              182. Consent.provision.period
                                              Definition

                                              The timeframe in this rule is valid.

                                              ShortTimeframe for this rule
                                              Control0..1
                                              TypePeriod
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              184. Consent.provision.period.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typeid
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              186. Consent.provision.period.extension
                                              Definition

                                              An Extension

                                              ShortExtension
                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Consent.provision.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 188. Consent.provision.period.extension:period
                                                Slice Nameperiod
                                                Definition

                                                STU3: Consent.except.period additional types (Period) additional types from child elements (end, start)

                                                ShortSTU3: Timeframe for this exception additional types
                                                Comments

                                                Element Consent.except.period is mapped to FHIR R4B element Consent.provision.period as SourceIsBroaderThanTarget. The mappings for Consent.except.period do not cover the following types: Period. The mappings for Consent.except.period do not cover the following types based on type expansion: end, start.

                                                Control0..1
                                                TypeExtension(STU3: Timeframe for this exception additional types) (Extension Type: Period)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                190. Consent.provision.period.start
                                                Definition

                                                The start of the period. The boundary is inclusive.

                                                ShortStarting time with inclusive boundary
                                                Comments

                                                If the low element is missing, the meaning is that the low boundary is not known.

                                                Control0..1
                                                This element is affected by the following invariants: per-1
                                                TypedateTime
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                192. Consent.provision.period.end
                                                Definition

                                                The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                ShortEnd time with inclusive boundary, if not ongoing
                                                Comments

                                                The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                Control0..1
                                                This element is affected by the following invariants: per-1
                                                TypedateTime
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                194. Consent.provision.actor
                                                Definition

                                                Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

                                                ShortWho|what controlled by this rule (or group, by role)
                                                Control0..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Meaning if MissingThere is no specific actor associated with the exception
                                                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                196. Consent.provision.actor.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                198. Consent.provision.actor.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                200. Consent.provision.actor.modifierExtension
                                                Definition

                                                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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                202. Consent.provision.actor.role
                                                Definition

                                                How the individual is involved in the resources content that is described in the exception.

                                                ShortHow the actor is involved
                                                Control1..1
                                                BindingUnless not suitable, these codes SHALL be taken from SecurityRoleType
                                                (extensible to http://hl7.org/fhir/ValueSet/security-role-type|4.3.0)

                                                How an actor is involved in the consent considerations.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                204. Consent.provision.actor.reference
                                                Definition

                                                The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').

                                                ShortResource for the actor (or group, by role)
                                                Control1..1
                                                TypeReference(Device, Group, CareTeam, Organization, Patient, Practitioner, RelatedPerson, PractitionerRole)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                206. Consent.provision.actor.reference.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typeid
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                208. Consent.provision.actor.reference.extension
                                                Definition

                                                An Extension

                                                ShortExtension
                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Consent.provision.actor.reference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 210. Consent.provision.actor.reference.extension:reference
                                                  Slice Namereference
                                                  Definition

                                                  STU3: Consent.actor.reference

                                                  ShortSTU3: reference
                                                  Comments

                                                  Element Consent.actor.reference is mapped to FHIR R4B element Consent.provision.actor.reference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.actor.reference with unmapped reference targets: CareTeam, Device, Group, Organization, Patient, Practitioner, RelatedPerson.

                                                  Control0..1
                                                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  212. Consent.provision.actor.reference.extension:reference
                                                  Slice Namereference
                                                  Definition

                                                  STU3: Consent.except.actor.reference

                                                  ShortSTU3: reference
                                                  Comments

                                                  Element Consent.except.actor.reference is mapped to FHIR R4B element Consent.provision.actor.reference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.except.actor.reference with unmapped reference targets: CareTeam, Device, Group, Organization, Patient, Practitioner, RelatedPerson.

                                                  Control0..1
                                                  TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  214. Consent.provision.actor.reference.reference
                                                  Definition

                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                  Comments

                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                  Control0..1
                                                  This element is affected by the following invariants: ref-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  216. Consent.provision.actor.reference.type
                                                  Definition

                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                  ShortType the reference refers to (e.g. "Patient")
                                                  Comments

                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                  Typeuri
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  218. Consent.provision.actor.reference.identifier
                                                  Definition

                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                  ShortLogical reference, when literal reference is not known
                                                  Comments

                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                  Control0..1
                                                  TypeIdentifier
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  220. Consent.provision.actor.reference.display
                                                  Definition

                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                  ShortText alternative for the resource
                                                  Comments

                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  222. Consent.provision.action
                                                  Definition

                                                  Actions controlled by this Rule.

                                                  ShortActions controlled by this rule
                                                  Comments

                                                  Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.

                                                  Control0..*
                                                  BindingFor example codes, see ConsentActionCodes
                                                  (example to http://hl7.org/fhir/ValueSet/consent-action|4.3.0)

                                                  Detailed codes for the consent action.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Meaning if Missingall actions
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  224. Consent.provision.securityLabel
                                                  Definition

                                                  A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.

                                                  ShortSecurity Labels that define affected resources
                                                  Comments

                                                  If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

                                                  Control0..*
                                                  BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                                                  (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.3.0)

                                                  Security Labels from the Healthcare Privacy and Security Classification System.

                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  226. Consent.provision.purpose
                                                  Definition

                                                  The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule.

                                                  ShortContext of activities covered by this rule
                                                  Comments

                                                  When the purpose of use tag is on the data, access request purpose of use shall not conflict.

                                                  Control0..*
                                                  BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse (3.1.0)
                                                  (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0)

                                                  What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.

                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  228. Consent.provision.class
                                                  Definition

                                                  The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.

                                                  Shorte.g. Resource Type, Profile, CDA, etc.
                                                  Comments

                                                  Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.

                                                  Control0..*
                                                  BindingUnless not suitable, these codes SHALL be taken from ConsentContentClass
                                                  (extensible to http://hl7.org/fhir/ValueSet/consent-content-class|4.3.0)

                                                  The class (type) of information a consent rule covers.

                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  230. Consent.provision.code
                                                  Definition

                                                  If this code is found in an instance, then the rule applies.

                                                  Shorte.g. LOINC or SNOMED CT code, etc. in the content
                                                  Comments

                                                  Typical use of this is a Document code with class = CDA.

                                                  Control0..*
                                                  BindingFor example codes, see ConsentContentCodes
                                                  (example to http://hl7.org/fhir/ValueSet/consent-content-code|4.3.0)

                                                  If this code is found in an instance, then the exception applies.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  232. Consent.provision.dataPeriod
                                                  Definition

                                                  Clinical or Operational Relevant period of time that bounds the data controlled by this rule.

                                                  ShortTimeframe for data controlled by this rule
                                                  Comments

                                                  This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

                                                  Control0..1
                                                  TypePeriod
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  234. Consent.provision.dataPeriod.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typeid
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  236. Consent.provision.dataPeriod.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Consent.provision.dataPeriod.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 238. Consent.provision.dataPeriod.extension:dataPeriod
                                                    Slice NamedataPeriod
                                                    Definition

                                                    STU3: Consent.dataPeriod additional types (Period) additional types from child elements (end, start)

                                                    ShortSTU3: Timeframe for data controlled by this consent additional types
                                                    Comments

                                                    Element Consent.dataPeriod is mapped to FHIR R4B element Consent.provision.dataPeriod as SourceIsBroaderThanTarget. The mappings for Consent.dataPeriod do not cover the following types: Period. The mappings for Consent.dataPeriod do not cover the following types based on type expansion: end, start. This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

                                                    Control0..1
                                                    TypeExtension(STU3: Timeframe for data controlled by this consent additional types) (Extension Type: Period)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    240. Consent.provision.dataPeriod.extension:dataPeriod
                                                    Slice NamedataPeriod
                                                    Definition

                                                    STU3: Consent.except.dataPeriod additional types (Period) additional types from child elements (end, start)

                                                    ShortSTU3: Timeframe for data controlled by this exception additional types
                                                    Comments

                                                    Element Consent.except.dataPeriod is mapped to FHIR R4B element Consent.provision.dataPeriod as SourceIsBroaderThanTarget. The mappings for Consent.except.dataPeriod do not cover the following types: Period. The mappings for Consent.except.dataPeriod do not cover the following types based on type expansion: end, start. This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

                                                    Control0..1
                                                    TypeExtension(STU3: Timeframe for data controlled by this exception additional types) (Extension Type: Period)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    242. Consent.provision.dataPeriod.start
                                                    Definition

                                                    The start of the period. The boundary is inclusive.

                                                    ShortStarting time with inclusive boundary
                                                    Comments

                                                    If the low element is missing, the meaning is that the low boundary is not known.

                                                    Control0..1
                                                    This element is affected by the following invariants: per-1
                                                    TypedateTime
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    244. Consent.provision.dataPeriod.end
                                                    Definition

                                                    The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                                                    ShortEnd time with inclusive boundary, if not ongoing
                                                    Comments

                                                    The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                                                    Control0..1
                                                    This element is affected by the following invariants: per-1
                                                    TypedateTime
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    246. Consent.provision.data
                                                    Definition

                                                    The resources controlled by this rule if specific resources are referenced.

                                                    ShortData controlled by this rule
                                                    Control0..*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summarytrue
                                                    Meaning if Missingall data
                                                    Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                                                    248. Consent.provision.data.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    250. Consent.provision.data.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    252. Consent.provision.data.modifierExtension
                                                    Definition

                                                    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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.

                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    254. Consent.provision.data.meaning
                                                    Definition

                                                    How the resource reference is interpreted when testing consent restrictions.

                                                    Shortinstance | related | dependents | authoredby
                                                    Control1..1
                                                    BindingThe codes SHALL be taken from ConsentDataMeaning
                                                    (required to http://hl7.org/fhir/ValueSet/consent-data-meaning|4.3.0)

                                                    How a resource reference is interpreted when testing consent restrictions.

                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    256. Consent.provision.data.reference
                                                    Definition

                                                    A reference to a specific resource that defines which resources are covered by this consent.

                                                    ShortThe actual data reference
                                                    Control1..1
                                                    TypeReference(Resource)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    258. Consent.provision.data.reference.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typeid
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    260. Consent.provision.data.reference.extension
                                                    Definition

                                                    An Extension

                                                    ShortExtension
                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Consent.provision.data.reference.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 262. Consent.provision.data.reference.extension:reference
                                                      Slice Namereference
                                                      Definition

                                                      STU3: Consent.data.reference additional types from child elements (display, identifier, reference)

                                                      ShortSTU3: reference additional types
                                                      Comments

                                                      Element Consent.data.reference is mapped to FHIR R4B element Consent.provision.data.reference as SourceIsBroaderThanTarget. The mappings for Consent.data.reference do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.data.reference with unmapped reference targets: Resource.

                                                      Control0..1
                                                      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      264. Consent.provision.data.reference.extension:reference
                                                      Slice Namereference
                                                      Definition

                                                      STU3: Consent.except.data.reference additional types from child elements (display, identifier, reference)

                                                      ShortSTU3: reference additional types
                                                      Comments

                                                      Element Consent.except.data.reference is mapped to FHIR R4B element Consent.provision.data.reference as SourceIsBroaderThanTarget. The mappings for Consent.except.data.reference do not cover the following types based on type expansion: display, identifier, reference. The standard extension alternate-reference has been mapped as the representation of FHIR STU3 element Consent.except.data.reference with unmapped reference targets: Resource.

                                                      Control0..1
                                                      TypeExtension(Alternate Reference) (Extension Type: Reference(Resource))
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      266. Consent.provision.data.reference.reference
                                                      Definition

                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                      Comments

                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                      Control0..1
                                                      This element is affected by the following invariants: ref-1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      268. Consent.provision.data.reference.type
                                                      Definition

                                                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                      ShortType the reference refers to (e.g. "Patient")
                                                      Comments

                                                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                      Control0..1
                                                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                      (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)
                                                      Typeuri
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      270. Consent.provision.data.reference.identifier
                                                      Definition

                                                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                      ShortLogical reference, when literal reference is not known
                                                      Comments

                                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                      Control0..1
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      272. Consent.provision.data.reference.display
                                                      Definition

                                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                                      ShortText alternative for the resource
                                                      Comments

                                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      274. Consent.provision.provision
                                                      Definition

                                                      Rules which provide exceptions to the base rule or subrules.

                                                      ShortNested Exception Rules
                                                      Control0..*
                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Consent#Consent.provision
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))