A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time.

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.

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 its narrative along with other profiles, value sets, etc.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

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.

An Extension

R4: PractitionerRole.availabilityExceptions (new:string)

Element PractitionerRole.availabilityExceptions has a context of PractitionerRole based on following the parent source element upwards and mapping to PractitionerRole. Element PractitionerRole.availabilityExceptions has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

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 managable, 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).

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.

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.

R4: PractitionerRole.availabilityExceptions (new:string)

Element PractitionerRole.availabilityExceptions has a context of PractitionerRole based on following the parent source element upwards and mapping to PractitionerRole. Element PractitionerRole.availabilityExceptions has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

R4: PractitionerRole.telecom additional types (ContactPoint) additional types from child elements (period, rank, system, use, value)

Element PractitionerRole.telecom is mapped to FHIR R5 element PractitionerRole.contact as SourceIsBroaderThanTarget. The mappings for PractitionerRole.telecom do not cover the following types: ContactPoint. The mappings for PractitionerRole.telecom do not cover the following types based on type expansion: period, rank, system, use, value.

R4: PractitionerRole.availableTime.daysOfWeek additional types (code) additional types from child elements (value)

Element PractitionerRole.availableTime.daysOfWeek is mapped to FHIR R5 element PractitionerRole.availability as SourceIsBroaderThanTarget. The mappings for PractitionerRole.availableTime.daysOfWeek do not cover the following types: code. The mappings for PractitionerRole.availableTime.daysOfWeek do not cover the following types based on type expansion: value.

R4: PractitionerRole.availableTime.allDay additional types (boolean) additional types from child elements (value)

Element PractitionerRole.availableTime.allDay is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.availableTime.allDay do not cover the following types: boolean. The mappings for PractitionerRole.availableTime.allDay do not cover the following types based on type expansion: value.

R4: PractitionerRole.availableTime.availableStartTime additional types (time) additional types from child elements (value)

Element PractitionerRole.availableTime.availableStartTime is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.availableTime.availableStartTime do not cover the following types: time. The mappings for PractitionerRole.availableTime.availableStartTime do not cover the following types based on type expansion: value. The timezone is expected to be for where this HealthcareService is provided at.

R4: PractitionerRole.availableTime.availableEndTime additional types (time) additional types from child elements (value)

Element PractitionerRole.availableTime.availableEndTime is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.availableTime.availableEndTime do not cover the following types: time. The mappings for PractitionerRole.availableTime.availableEndTime do not cover the following types based on type expansion: value. The timezone is expected to be for where this HealthcareService is provided at.

R4: PractitionerRole.notAvailable.description additional types (string) additional types from child elements (value)

Element PractitionerRole.notAvailable.description is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.notAvailable.description do not cover the following types: string. The mappings for PractitionerRole.notAvailable.description do not cover the following types based on type expansion: value.

R4: PractitionerRole.notAvailable.during additional types (Period) additional types from child elements (end, start)

Element PractitionerRole.notAvailable.during is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.notAvailable.during do not cover the following types: Period. The mappings for PractitionerRole.notAvailable.during do not cover the following types based on type expansion: end, start.

A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time.

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

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

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.

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.

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 its narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

IETF language tag for a human language

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.

Contained resources do not have a 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.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

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.

An Extension

R4: PractitionerRole.availabilityExceptions (new:string)

Element PractitionerRole.availabilityExceptions has a context of PractitionerRole based on following the parent source element upwards and mapping to PractitionerRole. Element PractitionerRole.availabilityExceptions has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

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 managable, 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).

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.

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.

Business Identifiers that are specific to a role/location.

A specific identifier value (e.g. Minnesota Registration ID) may appear on multiple PractitionerRole instances which could be for different periods, or different Roles (or other reasons). A specific identifier may be included multiple times in the same PractitionerRole instance with different identifier validity periods.

Often, specific identities are assigned for the agent.

Whether this practitioner role record is in active use. Some systems may use this property to mark non-active practitioners, such as those that are not currently employed.

If this value is false, you may refer to the period to see when the role was in active use. If there is no period specified, no inference can be made about when it was active.

Need to be able to mark a practitioner role record as not to be used because it was created in error, or otherwise no longer in active use.

The period during which the person is authorized to act as a practitioner in these role(s) for the organization.

If a practitioner is performing a role within an organization over multiple, non-adjacent periods, there should be a distinct PractitionerRole instance for each period. For example, if a nurse is employed at a hospital, leaves the organization for a period of time due to pandemic related stress, but returns post-pandemic to the same job role, there would be two PractitionerRole instances for the different periods of employment.

Even after the agencies is revoked, the fact that it existed must still be recorded.

Practitioner that is able to provide the defined services for the organization.

The organization where the Practitioner performs the roles associated.

Roles which this practitioner is authorized to perform for the organization.

A person may have more than one role.

The role a person plays representing an organization.

Need to know what authority the practitioner has - what can they do?

The specialty of a practitioner that describes the functional role they are practicing at a given organization or location.

The specialty represents the functional role a practitioner is playing within an organization/location. This role may require the individual have certain qualifications, which would be represented in the Practitioner.qualifications property. Note that qualifications may or might not relate to or be required by the practicing specialty.

Specific specialty associated with the agency.

The location(s) at which this practitioner provides care.

The list of healthcare services that this worker provides for this role's Organization/Location(s).

The contact details of communication devices available relevant to the specific PractitionerRole. This can include addresses, phone numbers, fax numbers, mobile numbers, email addresses and web sites.

Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these. Sometimes these also include a named person/organization that handles contact for specific purposes, such as a receptionist, or accounts clerk etc.

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

An Extension

R4: PractitionerRole.telecom additional types (ContactPoint) additional types from child elements (period, rank, system, use, value)

Element PractitionerRole.telecom is mapped to FHIR R5 element PractitionerRole.contact as SourceIsBroaderThanTarget. The mappings for PractitionerRole.telecom do not cover the following types: ContactPoint. The mappings for PractitionerRole.telecom do not cover the following types based on type expansion: period, rank, system, use, value.

The purpose/type of contact.

If no purpose is defined, then these contact details may be used for any purpose.

The purpose for which an extended contact detail should be used.

The name of an individual to contact, some types of contact detail are usually blank.

If there is no named individual, the telecom/address information is not generally monitored by a specific individual.

The contact details application for the purpose defined.

Address for the contact.

More than 1 address would be for different purposes, and thus should be entered as a different entry,.

This contact detail is handled/monitored by a specific organization. If the name is provided in the contact, then it is referring to the named individual within this organization.

Some specific types of contact information can be an handled by an organization (eg legal council is via a specific firm).

Period that this contact was valid for usage.

If the details have multiple periods, then enter in a new ExtendedContact with the new period.

Collection of characteristics (attributes).

These could be such things as is the service mode used by this role.

A custom attribute that could be provided at a service (e.g. Wheelchair accessibility).

A language the practitioner can use in patient communication. The practitioner may know several languages (listed in practitioner.communication), however these are the languages that could be advertised in a directory for a patient to search.

The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Note that for non-patient oriented communication, see Practitioner.communication. Note that all 'person' type resources (Person, RelatedPerson, Patient, Practitioner) have a communication structure that includes preferences. Role or service oriented resources such as HealthcareService and PractitionerRole only include languages that are available for interacting with patients.

IETF language tag for a human language

Knowing which language a practitioner speaks can help in facilitating patients to locate practitioners that speak their language.

A collection of times the practitioner is available or performing this role at the location and/or healthcareservice.

More detailed availability information may be provided in associated Schedule/Slot resources.

Systems may choose to render availability differently than it is exchanged on the interface. For example, rather than "Mon, Tue, Wed, Thur, Fri from 9am-12am; Mon, Tue, Wed, Thur, Fri from 1pm-5pm" as would be implied by two availableTime repetitions, an application could render this information as "Mon-Fri 9-12am and 1-5pm".

The NotAvailableTime(s) included indicate the general days/periods where the practitioner is not available (for things such as vacation time, or public holidays).

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

An Extension

R4: PractitionerRole.availableTime.daysOfWeek additional types (code) additional types from child elements (value)

Element PractitionerRole.availableTime.daysOfWeek is mapped to FHIR R5 element PractitionerRole.availability as SourceIsBroaderThanTarget. The mappings for PractitionerRole.availableTime.daysOfWeek do not cover the following types: code. The mappings for PractitionerRole.availableTime.daysOfWeek do not cover the following types based on type expansion: value.

R4: PractitionerRole.availableTime.allDay additional types (boolean) additional types from child elements (value)

Element PractitionerRole.availableTime.allDay is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.availableTime.allDay do not cover the following types: boolean. The mappings for PractitionerRole.availableTime.allDay do not cover the following types based on type expansion: value.

R4: PractitionerRole.availableTime.availableStartTime additional types (time) additional types from child elements (value)

Element PractitionerRole.availableTime.availableStartTime is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.availableTime.availableStartTime do not cover the following types: time. The mappings for PractitionerRole.availableTime.availableStartTime do not cover the following types based on type expansion: value. The timezone is expected to be for where this HealthcareService is provided at.

R4: PractitionerRole.availableTime.availableEndTime additional types (time) additional types from child elements (value)

Element PractitionerRole.availableTime.availableEndTime is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.availableTime.availableEndTime do not cover the following types: time. The mappings for PractitionerRole.availableTime.availableEndTime do not cover the following types based on type expansion: value. The timezone is expected to be for where this HealthcareService is provided at.

R4: PractitionerRole.notAvailable.description additional types (string) additional types from child elements (value)

Element PractitionerRole.notAvailable.description is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.notAvailable.description do not cover the following types: string. The mappings for PractitionerRole.notAvailable.description do not cover the following types based on type expansion: value.

R4: PractitionerRole.notAvailable.during additional types (Period) additional types from child elements (end, start)

Element PractitionerRole.notAvailable.during is mapped to FHIR R5 element PractitionerRole.availability as RelatedTo. The mappings for PractitionerRole.notAvailable.during do not cover the following types: Period. The mappings for PractitionerRole.notAvailable.during do not cover the following types based on type expansion: end, start.

Times the {item} is available.

A collection of times that the {item} is available.

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

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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.

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.

mon | tue | wed | thu | fri | sat | sun.

The purpose for which an extended contact detail should be used.

Indicates which days of the week are available between the start and end Times.

Always available? i.e. 24 hour service.

Is this always available? (hence times are irrelevant) i.e. 24 hour service.

Opening time of day (ignored if allDay = true).

The timezone is expected to be specified or implied by the context this datatype is used.

The opening time of day. Note: If the AllDay flag is set, then this time is ignored.

Closing time of day (ignored if allDay = true).

The timezone is expected to be specified or implied by the context this datatype is used.

The closing time of day. Note: If the AllDay flag is set, then this time is ignored.

Not available during this time due to provided reason.

The {item} is not available during this period of time due to the provided reason.

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

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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.

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.

Reason presented to the user explaining why time not available.

The reason will generally be provided to give the textual reason for displaying when the {item} is not available, e.g. 'Closed public holidays' or 'Independence Day'. In cases such as this, the during might not be included and local knowledge would be required in such cases (as don't desire to keep updating when the holiday occurs each year).

e.g.2: 'Closed for maintenance over the summer' for this example you would want to include the during period, unless this was a university hospital and the "summer" period was well known, but would recommend its inclusion anyway.

The reason that can be presented to the user as to why this time is not available.

Service not available during this period.

The {item} is not available (seasonally or for a public holiday) during this period.

Technical endpoints providing access to services operated for the practitioner with this role. Commonly used for locating scheduling services, or identifying where to send referrals electronically.

Organizations have multiple systems that provide various services and may also be different for practitioners too.

So the endpoint satisfies the need to be able to define the technical connection details for how to connect to them, and for what purpose.