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

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

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

An Extension

R4B: Communication.instantiatesUri (new:uri)

Element Communication.instantiatesUri has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.instantiatesUri has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

R4B: Communication.inResponseTo (new:Reference(Communication))

Element Communication.inResponseTo has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.inResponseTo has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R4B: Communication.priority (new:code)

Element Communication.priority has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.priority has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.

R4B: Communication.about (new:Reference(Resource))

Element Communication.about has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.about has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.

An Extension

R4B: Communication.status additional codes

Element Communication.status is mapped to FHIR STU3 element Communication.status as RelatedTo. Element Communication.status is mapped to FHIR STU3 element Communication.notDone as SourceIsBroaderThanTarget. The mappings for Communication.status do not allow expression of the necessary codes, per the bindings on the source and target. This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.

The status of the transmission.

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

The codes SHALL be taken from EventStatus http://hl7.org/fhir/ValueSet/event-status|3.0.2
(required to http://hl7.org/fhir/ValueSet/event-status|3.0.2)

The status of the communication.

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

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

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

R4B: Communication.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, source, tag, versionId)

Element Communication.meta is mapped to FHIR STU3 element Communication.meta as SourceIsBroaderThanTarget. The mappings for Communication.meta do not cover the following types: Meta. The mappings for Communication.meta do not cover the following types based on type expansion: lastUpdated, profile, security, source, tag, versionId.

R4B: Communication.text additional types (Narrative) additional types from child elements (div, status)

Element Communication.text is mapped to FHIR STU3 element Communication.text as SourceIsBroaderThanTarget. The mappings for Communication.text do not cover the following types: Narrative. The mappings for Communication.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 information is added later.

R4B: Communication.instantiatesUri (new:uri)

Element Communication.instantiatesUri has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.instantiatesUri has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

R4B: Communication.inResponseTo (new:Reference(Communication))

Element Communication.inResponseTo has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.inResponseTo has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R4B: Communication.priority (new:code)

Element Communication.priority has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.priority has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.

R4B: Communication.about (new:Reference(Resource))

Element Communication.about has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.about has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.

R4B: Communication.status additional codes

Element Communication.status is mapped to FHIR STU3 element Communication.status as RelatedTo. Element Communication.status is mapped to FHIR STU3 element Communication.notDone as SourceIsBroaderThanTarget. The mappings for Communication.status do not allow expression of the necessary codes, per the bindings on the source and target. This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.

R4B: Communication.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

Element Communication.identifier is mapped to FHIR STU3 element Communication.identifier as SourceIsBroaderThanTarget. The mappings for Communication.identifier do not cover the following types: Identifier. The mappings for Communication.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value. This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

R4B: Communication.instantiatesCanonical additional types (canonical(http://hl7.org/fhir/StructureDefinition/PlanDefinition), canonical(http://hl7.org/fhir/StructureDefinition/ActivityDefinition), canonical(http://hl7.org/fhir/StructureDefinition/Measure), canonical(http://hl7.org/fhir/StructureDefinition/OperationDefinition), canonical(http://hl7.org/fhir/StructureDefinition/Questionnaire))

Element Communication.instantiatesCanonical is mapped to FHIR STU3 element Communication.definition as SourceIsBroaderThanTarget. The mappings for Communication.instantiatesCanonical do not cover the following types: canonical.

R4B: Communication.basedOn additional types from child elements (display, identifier, reference, type)

Element Communication.basedOn is mapped to FHIR STU3 element Communication.basedOn as SourceIsBroaderThanTarget. The mappings for Communication.basedOn do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element Communication.basedOn with unmapped reference targets: Resource. This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc.

R4B: Communication.partOf additional types from child elements (display, identifier, reference, type)

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

R4B: Communication.subject additional types from child elements (display, identifier, reference, type)

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

R4B: Communication.recipient

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

R4B: Communication.topic additional types (CodeableConcept) additional types from child elements (coding, text)

Element Communication.topic is mapped to FHIR STU3 element Communication.topic as RelatedTo. The mappings for Communication.topic do not cover the following types: CodeableConcept. The mappings for Communication.topic do not cover the following types based on type expansion: coding, text. Communication.topic.text can be used without any codings.

R4B: Communication.encounter additional types from child elements (display, identifier, reference, type)

Element Communication.encounter is mapped to FHIR STU3 element Communication.context as SourceIsBroaderThanTarget. The mappings for Communication.encounter do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element Communication.encounter with unmapped reference targets: Encounter. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

R4B: Communication.sender

Element Communication.sender is mapped to FHIR STU3 element Communication.sender as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element Communication.sender with unmapped reference targets: Device, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson.

R4B: Communication.reasonReference

Element Communication.reasonReference is mapped to FHIR STU3 element Communication.reasonReference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element Communication.reasonReference with unmapped reference targets: Condition, DiagnosticReport, DocumentReference, Observation.

R4B: Communication.payload.content[x] additional types (Attachment)

Element Communication.payload.content[x] is mapped to FHIR STU3 element Communication.payload.content[x] as SourceIsBroaderThanTarget. The mappings for Communication.payload.content[x] do not cover the following types: Attachment. The target context Communication.payload.content[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Communication.payload. The standard extension alternate-reference has been mapped as PART of the representation of FHIR R4B element Communication.payload.content[x] with unmapped reference targets: Resource. Source element Communication.payload.content[x] has unmapped reference types. While the target element Communication.payload.content[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it.

R4B: Communication.payload.content[x] additional types (Attachment)

Element Communication.payload.content[x] is mapped to FHIR STU3 element Communication.payload.content[x] as SourceIsBroaderThanTarget. The mappings for Communication.payload.content[x] do not cover the following types: Attachment. The target context Communication.payload.content[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Communication.payload. The standard extension alternate-reference has been mapped as PART of the representation of FHIR R4B element Communication.payload.content[x] with unmapped reference targets: Resource. Source element Communication.payload.content[x] has unmapped reference types. While the target element Communication.payload.content[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it.

R4B: Communication.note additional types (Annotation) additional types from child elements (author[x], text, time)

Element Communication.note is mapped to FHIR STU3 element Communication.note as SourceIsBroaderThanTarget. The mappings for Communication.note do not cover the following types: Annotation. The mappings for Communication.note do not cover the following types based on type expansion: author[x], text, time.

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

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

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

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

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

An Extension

R4B: Communication.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, source, tag, versionId)

Element Communication.meta is mapped to FHIR STU3 element Communication.meta as SourceIsBroaderThanTarget. The mappings for Communication.meta do not cover the following types: Meta. The mappings for Communication.meta do not cover the following types based on type expansion: lastUpdated, profile, security, source, tag, versionId.

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

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.

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

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.

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

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.

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

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.

Security Labels from the Healthcare Privacy and Security Classification System.

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.

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.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"

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

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

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

The base language in which the resource is written.

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

A human language.

A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

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

An Extension

R4B: Communication.text additional types (Narrative) additional types from child elements (div, status)

Element Communication.text is mapped to FHIR STU3 element Communication.text as SourceIsBroaderThanTarget. The mappings for Communication.text do not cover the following types: Narrative. The mappings for Communication.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 information is added later.

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.

The status of a resource narrative

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

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 may not contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

An Extension

R4B: Communication.instantiatesUri (new:uri)

Element Communication.instantiatesUri has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.instantiatesUri has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

R4B: Communication.inResponseTo (new:Reference(Communication))

Element Communication.inResponseTo has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.inResponseTo has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

R4B: Communication.priority (new:code)

Element Communication.priority has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.priority has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.

R4B: Communication.about (new:Reference(Resource))

Element Communication.about has a context of Communication based on following the parent source element upwards and mapping to Communication. Element Communication.about has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.

An Extension

R4B: Communication.status additional codes

Element Communication.status is mapped to FHIR STU3 element Communication.status as RelatedTo. Element Communication.status is mapped to FHIR STU3 element Communication.notDone as SourceIsBroaderThanTarget. The mappings for Communication.status do not allow expression of the necessary codes, per the bindings on the source and target. This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.

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

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

An Extension

R4B: Communication.identifier additional types (Identifier) additional types from child elements (assigner, period, system, type, use, value)

Element Communication.identifier is mapped to FHIR STU3 element Communication.identifier as SourceIsBroaderThanTarget. The mappings for Communication.identifier do not cover the following types: Identifier. The mappings for Communication.identifier do not cover the following types based on type expansion: assigner, period, system, type, use, value. This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

The purpose of this identifier.

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Identifies the purpose for this identifier, if known .

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

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

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.

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

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

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

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.

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

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.

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

Organization that issued/manages the identifier.

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.

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

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

An Extension

R4B: Communication.instantiatesCanonical additional types (canonical(http://hl7.org/fhir/StructureDefinition/PlanDefinition), canonical(http://hl7.org/fhir/StructureDefinition/ActivityDefinition), canonical(http://hl7.org/fhir/StructureDefinition/Measure), canonical(http://hl7.org/fhir/StructureDefinition/OperationDefinition), canonical(http://hl7.org/fhir/StructureDefinition/Questionnaire))

Element Communication.instantiatesCanonical is mapped to FHIR STU3 element Communication.definition as SourceIsBroaderThanTarget. The mappings for Communication.instantiatesCanonical do not cover the following types: canonical.

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

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

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

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

An Extension

R4B: Communication.basedOn additional types from child elements (display, identifier, reference, type)

Element Communication.basedOn is mapped to FHIR STU3 element Communication.basedOn as SourceIsBroaderThanTarget. The mappings for Communication.basedOn do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element Communication.basedOn with unmapped reference targets: Resource. This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc.

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

Part of this action.

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

An Extension

R4B: Communication.partOf additional types from child elements (display, identifier, reference, type)

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

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

The status of the transmission.

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

The codes SHALL be taken from EventStatus
(required to http://hl7.org/fhir/ValueSet/event-status|3.0.2)

The status of the communication.

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

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

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

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

Codes for the reason why a communication was not done.

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

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

Codes for general categories of communications such as alerts, instruction, etc.

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

Codes for communication mediums such as phone, fax, email, in person, etc.

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

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

An Extension

R4B: Communication.subject additional types from child elements (display, identifier, reference, type)

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

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

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

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

An Extension

R4B: Communication.recipient

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

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

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

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

An Extension

R4B: Communication.topic additional types (CodeableConcept) additional types from child elements (coding, text)

Element Communication.topic is mapped to FHIR STU3 element Communication.topic as RelatedTo. The mappings for Communication.topic do not cover the following types: CodeableConcept. The mappings for Communication.topic do not cover the following types based on type expansion: coding, text. Communication.topic.text can be used without any codings.

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

The encounter within which the communication was sent.

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

An Extension

R4B: Communication.encounter additional types from child elements (display, identifier, reference, type)

Element Communication.encounter is mapped to FHIR STU3 element Communication.context as SourceIsBroaderThanTarget. The mappings for Communication.encounter do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element Communication.encounter with unmapped reference targets: Encounter. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

The time when this communication was sent.

The time when this communication arrived at the destination.

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

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

An Extension

R4B: Communication.sender

Element Communication.sender is mapped to FHIR STU3 element Communication.sender as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element Communication.sender with unmapped reference targets: Device, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson.

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

The reason or justification for the communication.

Textual reasons can be caprued using reasonCode.text.

Codes for describing reasons for the occurrence of a communication.

Indicates another resource whose existence justifies this communication.

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

An Extension

R4B: Communication.reasonReference

Element Communication.reasonReference is mapped to FHIR STU3 element Communication.reasonReference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element Communication.reasonReference with unmapped reference targets: Condition, DiagnosticReport, DocumentReference, Observation.

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.

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.

An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.

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.

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

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.

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

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

An Extension

R4B: Communication.payload.content[x] additional types (Attachment)

Element Communication.payload.content[x] is mapped to FHIR STU3 element Communication.payload.content[x] as SourceIsBroaderThanTarget. The mappings for Communication.payload.content[x] do not cover the following types: Attachment. The target context Communication.payload.content[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Communication.payload. The standard extension alternate-reference has been mapped as PART of the representation of FHIR R4B element Communication.payload.content[x] with unmapped reference targets: Resource. Source element Communication.payload.content[x] has unmapped reference types. While the target element Communication.payload.content[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it.

May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

R4B: Communication.payload.content[x] additional types (Attachment)

Element Communication.payload.content[x] is mapped to FHIR STU3 element Communication.payload.content[x] as SourceIsBroaderThanTarget. The mappings for Communication.payload.content[x] do not cover the following types: Attachment. The target context Communication.payload.content[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element Communication.payload. The standard extension alternate-reference has been mapped as PART of the representation of FHIR R4B element Communication.payload.content[x] with unmapped reference targets: Resource. Source element Communication.payload.content[x] has unmapped reference types. While the target element Communication.payload.content[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it.

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

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

An Extension

R4B: Communication.note additional types (Annotation) additional types from child elements (author[x], text, time)

Element Communication.note is mapped to FHIR STU3 element Communication.note as SourceIsBroaderThanTarget. The mappings for Communication.note do not cover the following types: Annotation. The mappings for Communication.note do not cover the following types based on type expansion: author[x], text, time.

The individual responsible for making the annotation.

Indicates when this particular annotation was made.

The text of the annotation.