The details of a healthcare service available at a location.

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: HealthcareService.offeredIn (new:Reference(HealthcareService))

Element HealthcareService.offeredIn has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.offeredIn has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example, if there is a generic Radiology service that offers CT Scans, MRIs, etc. You could have HealthcareService resources for the CT Scans and MRIs, which have an offeredIn reference to the Radiology HealthcareService.

R5: HealthcareService.contact (new:ExtendedContactDetail)

Element HealthcareService.contact has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.contact has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The address/telecom use code 'home' are not to be used. Note that these contacts are not the contact details of people who provide the service (that would be through PractitionerRole), these are official contacts for the HealthcareService itself for specific purposes. E.g. Mailing Addresses, Billing Addresses, Contact numbers for Booking or Billing Enquiries, general web address, web address for online bookings etc.

If this is empty (or the type of interest is empty), refer to the location's contacts.

R5: HealthcareService.program (new:CodeableConcept)

Element HealthcareService.program has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.program has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Programs are often defined externally to an Organization, commonly by governments; e.g. Home and Community Care Programs, Homeless Program, ….

R5: HealthcareService.communication (new:CodeableConcept)

Element HealthcareService.communication has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.communication has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When using this property it indicates that the service is available with this language, it is not derived from the practitioners, and not all are required to use this language, just that this language is available while scheduling.

May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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.

Whether this healthcareservice record is in active use.

This element is labeled as a modifier because it may be used to mark that the resource was created in error.

R5: HealthcareService.offeredIn (new:Reference(HealthcareService))

Element HealthcareService.offeredIn has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.offeredIn has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example, if there is a generic Radiology service that offers CT Scans, MRIs, etc. You could have HealthcareService resources for the CT Scans and MRIs, which have an offeredIn reference to the Radiology HealthcareService.

R5: HealthcareService.contact (new:ExtendedContactDetail)

Element HealthcareService.contact has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.contact has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The address/telecom use code 'home' are not to be used. Note that these contacts are not the contact details of people who provide the service (that would be through PractitionerRole), these are official contacts for the HealthcareService itself for specific purposes. E.g. Mailing Addresses, Billing Addresses, Contact numbers for Booking or Billing Enquiries, general web address, web address for online bookings etc.

If this is empty (or the type of interest is empty), refer to the location's contacts.

R5: HealthcareService.program (new:CodeableConcept)

Element HealthcareService.program has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.program has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Programs are often defined externally to an Organization, commonly by governments; e.g. Home and Community Care Programs, Homeless Program, ….

R5: HealthcareService.communication (new:CodeableConcept)

Element HealthcareService.communication has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.communication has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When using this property it indicates that the service is available with this language, it is not derived from the practitioners, and not all are required to use this language, just that this language is available while scheduling.

R5: HealthcareService.providedBy additional types from child elements (display, identifier, reference, type)

Element HealthcareService.providedBy is mapped to FHIR STU3 element HealthcareService.providedBy as SourceIsBroaderThanTarget. The mappings for HealthcareService.providedBy 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 HealthcareService.providedBy with unmapped reference targets: Organization. This property is recommended to be the same as the Location's managingOrganization, and if not provided should be interpreted as such. If the Location does not have a managing Organization, then this property should be populated.

R5: HealthcareService.location additional types from child elements (display, identifier, reference, type)

Element HealthcareService.location is mapped to FHIR STU3 element HealthcareService.location as SourceIsBroaderThanTarget. The mappings for HealthcareService.location 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 HealthcareService.location with unmapped reference targets: Location.

R5: HealthcareService.coverageArea additional types from child elements (display, identifier, reference, type)

Element HealthcareService.coverageArea is mapped to FHIR STU3 element HealthcareService.coverageArea as SourceIsBroaderThanTarget. The mappings for HealthcareService.coverageArea 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 HealthcareService.coverageArea with unmapped reference targets: Location. The locations referenced by the coverage area can include both specific locations, including areas, and also conceptual domains too (mode = kind), such as a physical area (tri-state area) and some other attribute (covered by Example Care Organization). These types of Locations are often not managed by any specific organization. This could also include generic locations such as "in-home".

R5: HealthcareService.endpoint additional types from child elements (display, identifier, reference, type)

Element HealthcareService.endpoint is mapped to FHIR STU3 element HealthcareService.endpoint as SourceIsBroaderThanTarget. The mappings for HealthcareService.endpoint 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 HealthcareService.endpoint with unmapped reference targets: Endpoint.

The details of a healthcare service available at a location.

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: HealthcareService.offeredIn (new:Reference(HealthcareService))

Element HealthcareService.offeredIn has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.offeredIn has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example, if there is a generic Radiology service that offers CT Scans, MRIs, etc. You could have HealthcareService resources for the CT Scans and MRIs, which have an offeredIn reference to the Radiology HealthcareService.

R5: HealthcareService.contact (new:ExtendedContactDetail)

Element HealthcareService.contact has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.contact has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The address/telecom use code 'home' are not to be used. Note that these contacts are not the contact details of people who provide the service (that would be through PractitionerRole), these are official contacts for the HealthcareService itself for specific purposes. E.g. Mailing Addresses, Billing Addresses, Contact numbers for Booking or Billing Enquiries, general web address, web address for online bookings etc.

If this is empty (or the type of interest is empty), refer to the location's contacts.

R5: HealthcareService.program (new:CodeableConcept)

Element HealthcareService.program has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.program has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Programs are often defined externally to an Organization, commonly by governments; e.g. Home and Community Care Programs, Homeless Program, ….

R5: HealthcareService.communication (new:CodeableConcept)

Element HealthcareService.communication has a context of HealthcareService based on following the parent source element upwards and mapping to HealthcareService. Element HealthcareService.communication has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). When using this property it indicates that the service is available with this language, it is not derived from the practitioners, and not all are required to use this language, just that this language is available while scheduling.

May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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.

External identifiers for this item.

Whether this healthcareservice record is in active use.

This element is labeled as a modifier because it may be used to mark that the resource was created in error.

The organization that provides this healthcare service.

This property is recommended to be the same as the Location's managingOrganization, and if not provided should be interpreted as such. If the Location does not have a managing Organization, then this property should be populated.

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: HealthcareService.providedBy additional types from child elements (display, identifier, reference, type)

Element HealthcareService.providedBy is mapped to FHIR STU3 element HealthcareService.providedBy as SourceIsBroaderThanTarget. The mappings for HealthcareService.providedBy 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 HealthcareService.providedBy with unmapped reference targets: Organization. This property is recommended to be the same as the Location's managingOrganization, and if not provided should be interpreted as such. If the Location does not have a managing Organization, then this property should be populated.

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.

Identifies the broad category of service being performed or delivered.

Selecting a Service Category then determines the list of relevant service types that can be selected in the primary service type.

A category of the service(s) that could be provided.

The specific type of service that may be delivered or performed.

Additional details about where the content was created (e.g. clinical specialty).

Collection of specialties handled by the service site. This is more of a medical term.

A specialty that a healthcare service may provide.

The location(s) where this healthcare service may be provided.

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: HealthcareService.location additional types from child elements (display, identifier, reference, type)

Element HealthcareService.location is mapped to FHIR STU3 element HealthcareService.location as SourceIsBroaderThanTarget. The mappings for HealthcareService.location 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 HealthcareService.location with unmapped reference targets: Location.

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.

Further description of the service as it would be presented to a consumer while searching.

Any additional description of the service and/or any specific issues not covered by the other attributes, which can be displayed as further detail under the serviceName.

Would expect that a user would not see this information on a search results, and it would only be available when viewing the complete details of the service.

Extra details about the service that can't be placed in the other fields.

If there is a photo/symbol associated with this HealthcareService, it may be included here to facilitate quick identification of the service in a list.

List of contacts related to this specific healthcare service.

If this is empty, then refer to the location's contacts.

The location(s) that this service is available to (not where the service is provided).

The locations referenced by the coverage area can include both specific locations, including areas, and also conceptual domains too (mode = kind), such as a physical area (tri-state area) and some other attribute (covered by Example Care Organization). These types of Locations are often not managed by any specific organization. This could also include generic locations such as "in-home".

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: HealthcareService.coverageArea additional types from child elements (display, identifier, reference, type)

Element HealthcareService.coverageArea is mapped to FHIR STU3 element HealthcareService.coverageArea as SourceIsBroaderThanTarget. The mappings for HealthcareService.coverageArea 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 HealthcareService.coverageArea with unmapped reference targets: Location. The locations referenced by the coverage area can include both specific locations, including areas, and also conceptual domains too (mode = kind), such as a physical area (tri-state area) and some other attribute (covered by Example Care Organization). These types of Locations are often not managed by any specific organization. This could also include generic locations such as "in-home".

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 code(s) that detail the conditions under which the healthcare service is available/offered.

The provision means being commissioned by, contractually obliged or financially sourced. Types of costings that may apply to this healthcare service, such if the service may be available for free, some discounts available, or fees apply.

The code(s) that detail the conditions under which the healthcare service is available/offered.

Does this service have specific eligibility requirements that need to be met in order to use the service?

Coded values underwhich a specific service is made available.

Describes the eligibility conditions for the service.

The description of service eligibility should, in general, not exceed one or two paragraphs. It should be sufficient for a prospective consumer to determine if they are likely to be eligible or not. Where eligibility requirements and conditions are complex, it may simply be noted that an eligibility assessment is required. Where eligibility is determined by an outside source, such as an Act of Parliament, this should be noted, preferably with a reference to a commonly available copy of the source document such as a web page.

Program Names that can be used to categorize the service.

Programs are often defined externally to an Organization, commonly by governments; e.g. Home and Community Care Programs, Homeless Program, ….

Collection of characteristics (attributes).

These could be such things as is wheelchair accessible.

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

Ways that the service accepts referrals, if this is not provided then it is implied that no referral is required.

The methods of referral can be used when referring to a specific HealthCareService resource.

Indicates whether or not a prospective consumer will require an appointment for a particular service at a site to be provided by the Organization. Indicates if an appointment is required for access to this service.

A collection of times that the Service Site is available.

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

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.

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

The days of the week.

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

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

The timezone is expected to be for where this HealthcareService is provided at.

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

The timezone is expected to be for where this HealthcareService is provided at.

The HealthcareService is not available during this period of time due to the provided reason.

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

May be used to represent additional information that is not part of the basic definition of the element. 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.

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

Service is not available (seasonally or for a public holiday) from this date.

A description of site availability exceptions, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as details in the available Times and not available Times.

Technical endpoints providing access to services operated for the specific healthcare services defined at this resource.

Organizations may have different systems covering different services at the different locations and need to be able to define the technical connection details for how to connect to them, and for what purpose.

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: HealthcareService.endpoint additional types from child elements (display, identifier, reference, type)

Element HealthcareService.endpoint is mapped to FHIR STU3 element HealthcareService.endpoint as SourceIsBroaderThanTarget. The mappings for HealthcareService.endpoint 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 HealthcareService.endpoint with unmapped reference targets: Endpoint.

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.