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

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

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

R5: Consent.period (new:Period)

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

R5: Consent.grantor (new:Reference(CareTeam,HealthcareService,Organization,Patient,Practitioner,RelatedPerson,PractitionerRole))

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

R5: Consent.manager (new:Reference(HealthcareService,Organization,Patient,Practitioner))

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

R5: Consent.controller (new:Reference(HealthcareService,Organization,Patient,Practitioner))

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

R5: Consent.policyText (new:Reference(DocumentReference))

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

R5: Consent.verification (new:BackboneElement)

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

R5: Consent.provision.actor.reference

Element Consent.provision.actor.reference is mapped to FHIR STU3 element Consent.actor.reference as SourceIsBroaderThanTarget. Element Consent.provision.actor.reference is mapped to FHIR STU3 element Consent.except.actor.reference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.provision.actor.reference with unmapped reference targets: CareTeam, Device, Group, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson.

R5: Consent.provision.data.reference additional types from child elements (display, identifier, reference, type)

Element Consent.provision.data.reference is mapped to FHIR STU3 element Consent.data.reference as SourceIsBroaderThanTarget. Element Consent.provision.data.reference is mapped to FHIR STU3 element Consent.except.data.reference as SourceIsBroaderThanTarget. The mappings for Consent.provision.data.reference 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 R5 element Consent.provision.data.reference with unmapped reference targets: Resource.

An Extension

R5: Consent.decision (new:code)

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

Indicates the current state of this consent.

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

The codes SHALL be taken from ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2
(required to http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2)

Indicates the state of the consent

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

An Extension

R5: Consent.status

Element Consent.status is mapped to FHIR STU3 element Consent.status as SourceIsBroaderThanTarget. The target context Consent.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.

The patient/healthcare consumer to whom this consent applies.

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

An Extension

R5: Consent.subject

Element Consent.subject is mapped to FHIR STU3 element Consent.patient as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.subject with unmapped reference targets: Group, Patient, Practitioner.

R5: Consent.period (new:Period)

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

R5: Consent.grantor (new:Reference(CareTeam,HealthcareService,Organization,Patient,Practitioner,RelatedPerson,PractitionerRole))

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

R5: Consent.manager (new:Reference(HealthcareService,Organization,Patient,Practitioner))

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

R5: Consent.controller (new:Reference(HealthcareService,Organization,Patient,Practitioner))

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

R5: Consent.policyText (new:Reference(DocumentReference))

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

R5: Consent.verification (new:BackboneElement)

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

R5: Consent.provision.actor.reference

Element Consent.provision.actor.reference is mapped to FHIR STU3 element Consent.actor.reference as SourceIsBroaderThanTarget. Element Consent.provision.actor.reference is mapped to FHIR STU3 element Consent.except.actor.reference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.provision.actor.reference with unmapped reference targets: CareTeam, Device, Group, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson.

R5: Consent.provision.data.reference additional types from child elements (display, identifier, reference, type)

Element Consent.provision.data.reference is mapped to FHIR STU3 element Consent.data.reference as SourceIsBroaderThanTarget. Element Consent.provision.data.reference is mapped to FHIR STU3 element Consent.except.data.reference as SourceIsBroaderThanTarget. The mappings for Consent.provision.data.reference 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 R5 element Consent.provision.data.reference with unmapped reference targets: Resource.

R5: Consent.decision (new:code)

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

R5: Consent.status

Element Consent.status is mapped to FHIR STU3 element Consent.status as SourceIsBroaderThanTarget. The target context Consent.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.

R5: Consent.subject

Element Consent.subject is mapped to FHIR STU3 element Consent.patient as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.subject with unmapped reference targets: Group, Patient, Practitioner.

R5: Consent.grantee

Element Consent.grantee is mapped to FHIR STU3 element Consent.consentingParty as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.grantee with unmapped reference targets: CareTeam, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson. In a fully computable consent, both grantee and grantor will be listed as actors within the consent. The Grantee and Grantor elements are for ease of search only.

R5: Consent.sourceReference

Element Consent.sourceReference is mapped to FHIR STU3 element Consent.source[x] as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.sourceReference with unmapped reference targets: Consent, Contract, DocumentReference, QuestionnaireResponse. Source element Consent.sourceReference has unmapped reference types. While the target element Consent.source[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

R5: Consent.regulatoryBasis additional types (CodeableConcept) additional types from child elements (coding, text)

Element Consent.regulatoryBasis is mapped to FHIR STU3 element Consent.policyRule as SourceIsBroaderThanTarget. The mappings for Consent.regulatoryBasis do not cover the following types: CodeableConcept. The mappings for Consent.regulatoryBasis do not cover the following types based on type expansion: coding, text.

R5: Consent.provision.expression (new:Expression)

Element Consent.provision.expression has a context of Consent.except based on following the parent source element upwards and mapping to Consent. Element Consent.provision.expression has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Constraining the expression type for a specific implementation via profile is recommended

R5: Consent.provision.provision (new:Consent.provision)

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

R5: Consent.provision.code additional types (CodeableConcept) additional types from child elements (text)

Element Consent.provision.code is mapped to FHIR STU3 element Consent.except.code as SourceIsBroaderThanTarget. The mappings for Consent.provision.code do not cover the following types: CodeableConcept. The mappings for Consent.provision.code do not cover the following types based on type expansion: text.

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

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

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.

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).

Unless not suitable, these codes SHALL be taken from Common Languages
(extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

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.

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

R5: Consent.period (new:Period)

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

R5: Consent.grantor (new:Reference(CareTeam,HealthcareService,Organization,Patient,Practitioner,RelatedPerson,PractitionerRole))

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

R5: Consent.manager (new:Reference(HealthcareService,Organization,Patient,Practitioner))

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

R5: Consent.controller (new:Reference(HealthcareService,Organization,Patient,Practitioner))

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

R5: Consent.policyText (new:Reference(DocumentReference))

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

R5: Consent.verification (new:BackboneElement)

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

R5: Consent.provision.actor.reference

Element Consent.provision.actor.reference is mapped to FHIR STU3 element Consent.actor.reference as SourceIsBroaderThanTarget. Element Consent.provision.actor.reference is mapped to FHIR STU3 element Consent.except.actor.reference as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.provision.actor.reference with unmapped reference targets: CareTeam, Device, Group, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson.

R5: Consent.provision.data.reference additional types from child elements (display, identifier, reference, type)

Element Consent.provision.data.reference is mapped to FHIR STU3 element Consent.data.reference as SourceIsBroaderThanTarget. Element Consent.provision.data.reference is mapped to FHIR STU3 element Consent.except.data.reference as SourceIsBroaderThanTarget. The mappings for Consent.provision.data.reference 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 R5 element Consent.provision.data.reference with unmapped reference targets: Resource.

An Extension

R5: Consent.decision (new:code)

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

Unique identifier for this copy of the Consent Statement.

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

Indicates the current state of this consent.

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

The codes SHALL be taken from ConsentState
(required to http://hl7.org/fhir/ValueSet/consent-state-codes|3.0.2)

Indicates the state of the consent

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

unique id for the element within a resource (for internal references)

An Extension

R5: Consent.status

Element Consent.status is mapped to FHIR STU3 element Consent.status as SourceIsBroaderThanTarget. The target context Consent.status is a modifier element, so this extension does not need to be defined as a modifier. This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.

Primitive value for code

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

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

The patient/healthcare consumer to whom this consent applies.

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

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

An Extension

R5: Consent.subject

Element Consent.subject is mapped to FHIR STU3 element Consent.patient as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.subject with unmapped reference targets: Group, Patient, Practitioner.

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.

Relevant time or time-period when this Consent is applicable.

This can be a subset of the period of the original statement.

When this Consent was issued / created / indexed.

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

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

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

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

An Extension

R5: Consent.grantee

Element Consent.grantee is mapped to FHIR STU3 element Consent.consentingParty as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.grantee with unmapped reference targets: CareTeam, HealthcareService, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson. In a fully computable consent, both grantee and grantor will be listed as actors within the consent. The Grantee and Grantor elements are for ease of search only.

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.

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

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.

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.

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

Unless not suitable, these codes SHALL be taken from SecurityRoleType
(extensible to http://hl7.org/fhir/ValueSet/security-role-type|1.8.0)

How an actor is involved in the consent considerations

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

Actions controlled by this consent.

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

Detailed codes for the consent action.

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

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

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

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

An Extension

R5: Consent.sourceReference

Element Consent.sourceReference is mapped to FHIR STU3 element Consent.source[x] as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element Consent.sourceReference with unmapped reference targets: Consent, Contract, DocumentReference, QuestionnaireResponse. Source element Consent.sourceReference has unmapped reference types. While the target element Consent.source[x] is a choice type and does not allow extensions, the alternate-reference extension can be applied to Reference values within it. The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

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

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.

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.

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

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

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

A referece to the specific computable policy.

If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.

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

unique id for the element within a resource (for internal references)

An Extension

R5: Consent.regulatoryBasis additional types (CodeableConcept) additional types from child elements (coding, text)

Element Consent.regulatoryBasis is mapped to FHIR STU3 element Consent.policyRule as SourceIsBroaderThanTarget. The mappings for Consent.regulatoryBasis do not cover the following types: CodeableConcept. The mappings for Consent.regulatoryBasis do not cover the following types based on type expansion: coding, text.

The actual value

A set of security labels that define which resources are controlled by this consent. If more than one label is specified, all resources must have all the specified labels.

If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?).

Unless not suitable, these codes SHALL be taken from All Security Labels
(extensible to http://hl7.org/fhir/ValueSet/security-labels|3.0.2)

Security Labels from the Healthcare Privacy and Security Classification System.

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

This element is for discoverability / documentation, and does not modify or qualify the policy (e.g. the policy itself describes the purposes for which it applies).

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

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

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

The resources controlled by this consent, if specific resources are referenced.

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.

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.

How the resource reference is interpreted when testing consent restrictions.

How a resource reference is interpreted when testing consent restrictions

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

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

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

An Extension

R5: Consent.provision.expression (new:Expression)

Element Consent.provision.expression has a context of Consent.except based on following the parent source element upwards and mapping to Consent. Element Consent.provision.expression has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Constraining the expression type for a specific implementation via profile is recommended

R5: Consent.provision.provision (new:Consent.provision)

Element Consent.provision.provision has a context of Consent.except based on following the parent source element upwards and mapping to Consent. Element Consent.provision.provision has no mapping targets in FHIR STU3. 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 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.

Action to take - permit or deny - when the exception conditions are met.

How an exception statement is applied, such as adding additional consent or removing consent

The timeframe in this exception is valid.

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

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.

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.

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

Unless not suitable, these codes SHALL be taken from SecurityRoleType
(extensible to http://hl7.org/fhir/ValueSet/security-role-type|1.8.0)

How an actor is involved in the consent considerations

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

Actions controlled by this Exception.

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

Detailed codes for the consent action.

A set of security labels that define which resources are controlled by this exception. If more than one label is specified, all resources must have all the specified labels.

If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. Not all of the security labels make sense for use in this element (may define a narrower value set?).

Unless not suitable, these codes SHALL be taken from All Security Labels
(extensible to http://hl7.org/fhir/ValueSet/security-labels|3.0.2)

Security Labels from the Healthcare Privacy and Security Classification System.

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

E.g. if the purpose is 'research', then the operational context must be research, in order for the consent to apply. Not all of the security labels make sense for use in this element (may define a narrower value set?).

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

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

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

The class (type) of information a consent rule covers

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

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

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

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

An Extension

R5: Consent.provision.code additional types (CodeableConcept) additional types from child elements (text)

Element Consent.provision.code is mapped to FHIR STU3 element Consent.except.code as SourceIsBroaderThanTarget. The mappings for Consent.provision.code do not cover the following types: CodeableConcept. The mappings for Consent.provision.code do not cover the following types based on type expansion: text.

The identification of the code system that defines the meaning of the symbol in the code.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

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

The resources controlled by this exception, if specific resources are referenced.

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.

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.

How the resource reference is interpreted when testing consent restrictions.

How a resource reference is interpreted when testing consent restrictions

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