Das CapabilityStatement in dieser Spezifikation stellt die Anforderungen seitens der gematik dar (kind = "requirements"). Zur Unterscheidung von Anforderungen, die erfüllt werden MÜSSEN, gegenüber jenen, die erfüllt werden KÖNNEN, wird die CapabilityStatement-Expectation-Extension mit den möglichen Werten "SHALL" (=MUSS) und "MAY" (=KANN) verwendet.
+
Eine Server-Instanz MUSS ihrerseits ein CapabilityStatement vom kind= "instance" liefern und im Element software den Namen und die Versionsnummer angeben.
+
Das CapabilityStatement der Instanz MUSS alle Funktionalitäten auflisten, die im folgenden CapabilityStatement mit "SHALL" gekennzeichnet sind. Das CapabilityStatement KANN darüber hinaus die mit "MAY" gekennzeichneten Funktionalitäten, sowie weitere Funktionalitäten auflisten, sofern diese in der Instanz implementiert wurden.
+
Die Verwendung der CapabilityStatement-Expectation-Extension ist im CapabilityStatement der Server-Instanz nicht erforderlich.
ISiKBinary dient im Kontext der Terminplanung dazu Zusatzinformationen an das Termin-Repository bzw. den Termin-Requestor zu übermitteln. Die Ressource ist im ISIK Terminplanungsmodul in der ISiKNachricht vorgesehen (vgl. 'ISiKCommunication.payload.contentAttachment').
+
Normativer Status
+
Da die ISiKNachricht NICHT unterstützt werden MUSS, gilt für die ISiKBinary: diese MUSS unterstützt werden, falls eine ISiKNachricht unterstützt wird.
+
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FHIR-Profil
+
Es gelten bis auf weiteres die Vorgaben des ISiK Basismoduls für das Profil 'ISiKBinary'.
+Ein Termin Repository SOLL die Anlage (Create-Interaktion) einer Binary-Ressource entsprechend der Vorgaben des ISiK-Basismoduls unterstützen.
+Die Binary-Ressource SOLL in ihrem originalen Repräsentationsformat, sowie als FHIR-Ressource abgerufen werden können (vgl. Serving Binary Resources using the RESTful API).
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+ Implementierungsleitfaden ISiK-Terminplanung
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Das Datenobjekt ISiKKalender bietet die Möglichkeit Kalender für verschiedene Akteure (Practitioner, Device, HealthcareService) zu exponieren, sodass für die Ressourcen Termine gebucht werden können.
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
Mappings
rim: Entity. Role, or Act
rim: n/a
ical: BEGIN:VFREEBUSY ??? END:VFREEBUSY (If your fhir server provides this information via calDAV, then you may want to include addressing information in a URL section, and with the search, a DTSTART and DTEND component can be included to indicate the range of time that has been covered in the collection of slots, where these overlap the resources period values. For all slots that reference this resource, include a FREEBUSY row for each slot)
There are no (further) constraints on this element
Element id
Schedule.meta
Short description
Metadata about the resource
Definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
There are no (further) constraints on this element
Element id
Schedule.implicitRules
Short description
A set of rules under which this content was created
Definition
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
+
Comments
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
There are no (further) constraints on this element
Element id
Schedule.language
Short description
Language of the resource content
Definition
The base language in which the resource is written.
+
Comments
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
There are no (further) constraints on this element
Element id
Schedule.text
Short description
Text summary of the resource, for human interpretation
Alternate names
narrative, html, xhtml, display
Definition
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
+
Comments
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
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.
+
Comments
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
There are no (further) constraints on this element
Element id
Schedule.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Schedule.extension.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Schedule.extension.url
Short description
identifies the meaning of the extension
Definition
Source of the definition for the extension code - a logical name or a URL.
+
Comments
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Schedule.modifierExtension
Short description
Extensions that cannot be ignored
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Schedule.serviceCategory
Short description
High-level category
Definition
A broad categorization of the service that is to be performed during this appointment.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Schedule.serviceType
Short description
Specific service
Definition
The specific service that is to be performed during this appointment.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
The specialty of a practitioner that would be required to perform the service requested in this appointment.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
The specialty of a practitioner that would be required to perform the service requested in this appointment.
+
Comments
Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024).
The specialty of a practitioner that would be required to perform the service requested in this appointment.
+
Comments
Dieses ValueSet KANN über ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verknüpft werden und darüber ggf. die Integration von Systemen erleichtern.
Resource(s) that availability information is being provided for
Definition
Slots that reference this schedule resource provide the availability details to these referenced resource(s).
+
Comments
The capacity to support multiple referenced resource types should be used in cases where the specific resources themselves cannot be scheduled without the other, and thus only make sense to the system exposing them as a group. Common examples of this are where the combination of a practitioner and a room (Location) are always required by a system.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.subject[x]
ical: ATTENDEE:MAILTO:john_public@host2.com This can be populated with a value from the referenced resource
There are no (further) constraints on this element
Element id
Schedule.actor.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Schedule.actor.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Schedule.actor.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Schedule.actor.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Schedule.actor.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Resource(s) that availability information is being provided for
Definition
Slots that reference this schedule resource provide the availability details to these referenced resource(s).
+
Comments
Im ISIK-Kontext MUSS die referenzierte Practitioner-Ressource konform zum ISiKPersonImGesundheitsberuf des Basismoduls sein. Zudem MUSS die referenzierte Location-Ressource konform zum ISiKStandort des Basismoduls sein. Dieses Element dient dazu, um alle Akteure zu gruppieren, sodass für diese Einheit von Terminressourcen ein Terminblock herausgegeben werden kann. Unter 'Akteure' fallen hier auch Standorte und Dienstleistungen.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
w5: FiveWs.subject[x]
ical: ATTENDEE:MAILTO:john_public@host2.com This can be populated with a value from the referenced resource
There are no (further) constraints on this element
Element id
Schedule.actor:Akteur.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Schedule.actor:Akteur.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Schedule.actor:Akteur.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Schedule.actor:Akteur.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Schedule.actor:Akteur.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Schedule.planningHorizon
Short description
Period of time covered by schedule
Definition
The period of time that the slots that reference this Schedule resource cover (even if none exist). These cover the amount of time that an organization's planning horizon; the interval for which they are currently accepting appointments. This does not define a "template" for planning outside these dates.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
Hinweis: Im alltäglichen Kontext besitzen Kalender neben der Zugehörigkeit zu einer Ressource teilweise einen Namen. Dieser muss nicht zwingend ein eineindeutiger Identifier sein. Aufgrund dessen kann dieser Name zusätzlich abgebildet werden. Falls kein Name angegeben wird, kann ein Termin-Consumer einen Namen z.B. aus den Elementen "serviceType" oder "specialty" für Anzeigezwecke ableiten.
+
Schedule.active
+
Bedeutung: Ist der Kalender in aktiver Verwendung?
+
Hinweis: Historische Kalender können ebenfalls über die ISiK-Schnittstelle ausgetauscht werden. Für diese dürfen jedoch keine Termine vereinbart werden. Das terminführende System MUSS dies bei der Buchung überprüfen.
+
Schedule.serviceType
+
Bedeutung: Welche Besuchsgründe / Behandlungsleistungen werden durch diesen Kalender erfasst?
+
Hinweis: Die Besuchsgründe / Behandlungsleistungen SOLLEN im Schedule angegeben werden, falls unter Schedule.actor nur Referenzen mit Referenz.display angegeben werden oder direkt auf einen Practitioner referenziert wird. Im Falle, dass ein HealthcareService referenziert wird, SOLLEN die gleichen Informationen wie in HealthcareService.type angegeben werden. Seitens der aktuellen Spezifikation werden keine Vorgaben bezüglich der zu verwendenden Terminologie gemacht. Entsprechend verwendete Kataloge müssen als CodeSystem-Ressource exponiert werden.
+
Schedule.specialty
+
Bedeutung: Welche Fachrichtung(en) führen die Behandlungsleistungen, die durch diesen Kalender erfasst werden, aus?
+
Hinweis: Die Fachrichtung(en) SOLL(EN) im Schedule angegeben werden, falls unter Schedule.actor nur Referenzen mit Referenz.display angegeben werden oder direkt auf einen Practitioner referenziert wird. Im Falle, dass ein HealthcareService referenziert wird, SOLLEN die gleichen Informationen wie in HealthcareService.specialty angegeben werden.
+
Schedule.actor
+
Bedeutung: Für welche Akteure wird der Kalender geführt?
+
Hinweis: Nicht alle Target-Ressourcen dieser Referenz existieren als Profil innerhalb des ISiK-Basismoduls oder ISiK-Terminplanung. Für alle Target-Ressourcen SOLL ein Displaywert für die Referenz angegeben werden. Nur für HealthcareService und Practitioner MUSS Reference.reference angegeben werden.
+
+
Interaktionen
+
Für die Ressource Schedule MUSS die REST-Interaktion "READ" implementiert werden.
Unter einer medizinischen Behandlungseinheit wird hier im weiten Sinne eine Dienstleistung (diagnostisch, therapeutisch, im weiten Sinne gesundheitsfördernd etc.) zum Zweck einer Terminbuchung verstanden. Hierfür können von der Fachabteilung (Organization) unabhängige Kalender gepflegt werden. Im Kontext der Terminplanung können somit angebotene Leistungen (z.B. CT/MRT-Untersuchungen, chirurgische Eingriffe, Beratungsstunden zur Geburt etc.) abgebildet werden.
+
Der Kontext zu diesem Profil wird mit folgender User Story veranschaulicht:
+
User Story: Ein Patient erhält von seiner Hausärztin einen Überweisungsschein für eine weitere diagnostische Untersuchung in Form einer Kapselendoskopie der Speiseröhre. Der Patient nutzt ein Patientenportal, um unter Angabe der benötigten diagnostische Leistung nach einem verfügbaren Termin zu suchen und findet einen passenden Termin bei der Fachabteilung für Gastroenterologie eines örtlichen Krankenhauses.
+
Hintergrund: Die Suche nach verfügbaren Terminenblöcken (Slot) unter Einbeziehung der Dienstleistung entspricht der Angabe des Überweisungsscheins, ermöglicht hier zugleich eine präzisere Suche und vergrößert darüber hinaus den Raum möglicher Termine über verschiedene Abteilungen (und Institutionen im Patientenportal) hinweg.
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
There are no (further) constraints on this element
Element id
HealthcareService.meta
Short description
Metadata about the resource
Definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
There are no (further) constraints on this element
Element id
HealthcareService.implicitRules
Short description
A set of rules under which this content was created
Definition
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
+
Comments
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
There are no (further) constraints on this element
Element id
HealthcareService.language
Short description
Language of the resource content
Definition
The base language in which the resource is written.
+
Comments
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
There are no (further) constraints on this element
Element id
HealthcareService.text
Short description
Text summary of the resource, for human interpretation
Alternate names
narrative, html, xhtml, display
Definition
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
+
Comments
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
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.
+
Comments
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
There are no (further) constraints on this element
Element id
HealthcareService.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
HealthcareService.modifierExtension
Short description
Extensions that cannot be ignored
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
HealthcareService.active
Short description
Whether this HealthcareService record is in active use
Definition
This flag is used to mark the record to not be used. This is not used when a center is closed for maintenance, or for holidays, the notAvailable period is to be used for this.
+
Comments
This element is labeled as a modifier because it may be used to mark that the resource was created in error.
+
Meaning when missing
This resource is generally assumed to be active if no value is provided for the active element
There are no (further) constraints on this element
Element id
HealthcareService.providedBy
Short description
Organization that provides this service
Definition
The organization that provides this healthcare service.
+
Comments
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.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
HealthcareService.type
Short description
Type of service that may be delivered or performed
Alternate names
service type
Definition
The specific type of service that may be delivered or performed.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Collection of specialties handled by the service site. This is more of a medical term.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Collection of specialties handled by the service site. This is more of a medical term.
+
Comments
Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024).
Collection of specialties handled by the service site. This is more of a medical term.
+
Comments
Dieses ValueSet KANN über ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verknüpft werden und darüber ggf. die Integration von Systemen erleichtern.
There are no (further) constraints on this element
Element id
HealthcareService.location
Short description
Location(s) where service may be provided
Definition
The location(s) where this healthcare service may be provided.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
HealthcareService.comment
Short description
Additional description and/or any specific issues not covered elsewhere
Definition
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.
+
Comments
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.
There are no (further) constraints on this element
Element id
HealthcareService.extraDetails
Short description
Extra details about the service that can't be placed in the other fields
Definition
Extra details about the service that can't be placed in the other fields.
+
Comments
Systems are not required to have markdown support, so the text should be readable without markdown processing. The markdown syntax is GFM - see https://github.github.com/gfm/
There are no (further) constraints on this element
Element id
HealthcareService.photo
Short description
Facilitates quick identification of the service
Definition
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.
+
Comments
When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".
There are no (further) constraints on this element
Element id
HealthcareService.coverageArea
Short description
Location(s) service is intended for/available to
Definition
The location(s) that this service is available to (not where the service is provided).
+
Comments
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".
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
HealthcareService.serviceProvisionCode
Short description
Conditions under which service is available/offered
Definition
The code(s) that detail the conditions under which the healthcare service is available/offered.
+
Comments
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.
There are no (further) constraints on this element
Element id
HealthcareService.eligibility.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
HealthcareService.eligibility.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
HealthcareService.eligibility.code
Short description
Coded value for the eligibility
Definition
Coded value for the eligibility.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
HealthcareService.eligibility.comment
Short description
Describes the eligibility conditions for the service
Definition
Describes the eligibility conditions for the service.
+
Comments
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.
There are no (further) constraints on this element
Element id
HealthcareService.communication
Short description
The language that this service is offered in
Definition
Some services are specifically made available in multiple languages, this property permits a directory to declare the languages this is offered in. Typically this is only provided where a service operates in communities with mixed languages used.
+
Comments
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.
There are no (further) constraints on this element
Element id
HealthcareService.referralMethod
Short description
Ways that the service accepts referrals
Definition
Ways that the service accepts referrals, if this is not provided then it is implied that no referral is required.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
HealthcareService.appointmentRequired
Short description
If an appointment is required for access to this service
Definition
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.
There are no (further) constraints on this element
Element id
HealthcareService.availableTime.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
HealthcareService.availableTime.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
HealthcareService.notAvailable.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
HealthcareService.notAvailable.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
HealthcareService.notAvailable.during
Short description
Service not available from this date
Definition
Service is not available (seasonally or for a public holiday) from this date.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
HealthcareService.availabilityExceptions
Short description
Description of availability exceptions
Definition
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.
+
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
There are no (further) constraints on this element
Element id
HealthcareService.endpoint
Short description
Technical endpoints providing access to electronic services operated for the healthcare service
Definition
Technical endpoints providing access to services operated for the specific healthcare services defined at this resource.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
+
Folgende FHIRPath-Constraints sind im Profil zu beachten:
+
Die Verknüpfung mit anderen Parametern, wie beteiligten Akteuren, erfolgt über ISiKTermin (Appointment) oder ISiKKalender (Schedule).
Bedeutung: Ist der HealthcareService in aktiver Verwendung.
+
Hinweis: Historische HealthcareServices können ebenfalls über die ISiK-Schnittstelle ausgetauscht werden. Für diese dürfen jedoch keine Termine vereinbart werden. Das terminführende System MUSS dies bei der Buchung überprüfen.
+
HealthcareService.type
+
Bedeutung: Klassifikation der Behandlungsleistung welche durch den HealthcareService erbracht wird
+
Hinweis: Diese Klassifikation SOLL stets auch in Appointment.serviceType und Schedule.serviceType angegeben werden. Seitens der aktuellen Spezifikation werden keine Vorgaben bezüglich der zu verwendenden Terminologie gemacht. Entsprechend verwendete Kataloge müssen als CodeSystem- und ValueSet-Ressourcen exponiert werden. Siehe Suchparameter "context-type-value" in ISiK Basis - Datenobjekt ValueSet.
+
HealthcareService.specialty
+
Bedeutung: Fachrichtung der Behandlungsleistung welche durch den HealthcareService erbracht wird
+
Hinweis: Diese Fachrichtung SOLL stets auch in Appointment.specialty und Schedule.specialty angegeben werden.
+
HealthcareService.name
+
Bedeutung: Informeller Name der Behandlungseinheit
+
Hinweis: Es wird im Rahmen dieser Spezifikation davon ausgegangen, dass für einen HealthcareService keine natürlichen Identifier vorliegen, die in einem realen Kontext vergeben werden. Somit kann durch den Namen ein informeller, jedoch identifizierender Bezeichner vergeben werden.
+
+
Interaktionen
+
Für die Ressource HealthcareService MUSS die REST-Interaktion "READ" implementiert werden.
Die Communication-Ressource dient als Datenobjekt für den bidirektionalen Austausch von Nachrichten zwischen einem Leistungserbringer und einem Patienten. Es können sowohl Textnachrichten als auch Binärdateien ausgetauscht werden.
+
Zu einer Liste angrenzender Use Cases siehe Abschnitt zur Benachrichtigung unter Anwendungsfälle (Use Cases) - hier wird der spezifische Use Case für dieses Profil von anderen abgegrenzt.
+
Es liegt in der Verantwortung des bestätigungsrelevanten Systems, eine dem Schutzbedarf der ausgetauschten Nachrichten angemessene Sicherheit in Bezug auf Vertraulichkeit, Integrität und Verfügbarkeit herzustellen. Die Vorgaben des BSI, z. B. aus der TR-03161, sind zu beachten. Grundsätzlich liegen der vorliegenden Definition von ISiKNachricht die folgenden Annahmen zugrunde, die auch eine Nutzung einfach umsetzbarer Sicherheitsmaßnahmen ermöglichen:
+
+
ISiKNachricht SOLL ausschließlich für den Austausch administrativer, nicht personenbezogener Informationen im Kontext der Terminbuchung verwendet werden, z. B. zur Übermittlung von Coronahinweisen oder Lageplänen.
+
Der Austausch personenbezogener medizinischer Daten SOLL ausschließlich über die dafür vorgesehenen sicheren Dienste der Telematikinfrastruktur, wie z. B. ePA und zukünftig auch den TI-Messenger, erfolgen.
+
+
Normativer Status und Bestätigung
+
Dieses Profil MUSS im Rahmen der Bestätigung NICHT unterstützt werden. Falls das Profil unterstützt werden soll, MÜSSEN die hier definierten Festlegungen greifen (auch im Bestätigungsverfahren; in diesem Sinn sind auch die SHALL-Vorgaben im CapabilityStatement als bedingte zu verstehen).
There are no (further) constraints on this element
Element id
Communication
Short description
A record of information transmitted from a sender to a receiver
Definition
An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency that was notified about a reportable condition.
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
There are no (further) constraints on this element
Element id
Communication.meta
Short description
Metadata about the resource
Definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
There are no (further) constraints on this element
Element id
Communication.implicitRules
Short description
A set of rules under which this content was created
Definition
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
+
Comments
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
There are no (further) constraints on this element
Element id
Communication.language
Short description
Language of the resource content
Definition
The base language in which the resource is written.
+
Comments
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
There are no (further) constraints on this element
Element id
Communication.text
Short description
Text summary of the resource, for human interpretation
Alternate names
narrative, html, xhtml, display
Definition
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
+
Comments
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
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.
+
Comments
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
There are no (further) constraints on this element
Element id
Communication.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Communication.modifierExtension
Short description
Extensions that cannot be ignored
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Communication.identifier
Short description
Unique identifier
Definition
Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
+
Requirements
Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.
+
Comments
This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Communication.instantiatesUri
Short description
Instantiates external protocol or definition
Definition
The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.
+
Comments
This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Communication.partOf
Short description
Part of this action
Alternate names
container
Definition
Part of this action.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Communication.inResponseTo
Short description
Reply to
Definition
Prior communication that this communication is in response to.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.
There are no (further) constraints on this element
Element id
Communication.statusReason
Short description
Reason for current status
Alternate names
Suspended Reason, Cancelled Reason
Definition
Captures the reason for the current state of the Communication.
+
Comments
This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.
There are no (further) constraints on this element
Element id
Communication.medium
Short description
A channel of communication
Definition
A channel that was used for this communication (e.g. email, fax).
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Communication.encounter
Short description
Encounter created as part of
Definition
The Encounter during which this Communication was created or to which the creation of this record is tightly associated.
+
Comments
This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).
+
Comments
Im ISIK-Kontext MUSS die referenzierte Practitioner-Ressource konform zum ISiKPersonImGesundheitsberuf des Basismoduls sein.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Communication.recipient.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Communication.recipient.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Communication.recipient.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Communication.recipient.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Communication.recipient.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Communication.recipient:ISiKRecipient.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Communication.recipient:ISiKRecipient.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Communication.recipient:ISiKRecipient.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Communication.recipient:ISiKRecipient.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Communication.recipient:ISiKRecipient.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Communication.sender
Short description
Message sender
Definition
The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Communication.sender.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Communication.sender.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Communication.sender.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Communication.sender.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Communication.sender.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Communication.reasonReference
Short description
Why was communication done?
Definition
Indicates another resource whose existence justifies this communication.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Communication.payload.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Communication.payload.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.
+
Requirements
Processors of the data need to be able to know how to interpret the data.
+
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.
The calculated hash of the data using SHA-1. Represented using base64.
+
Requirements
Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).
+
Comments
The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.
There are no (further) constraints on this element
Element id
Communication.note
Short description
Comments made about the communication
Definition
Additional notes or commentary about the communication by the sender, receiver or other interested parties.
+
Comments
For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: N/A
rim: Act
workflow: Event.note
+
Folgende FHIRPath-Constraints sind im Profil zu beachten:
+
+
Anmerkungen zu Must-Support-Feldern
+
Communication.inResponseTo
+
Bedeutung: Falls die Communication-Ressource in einen zeitlichen Zusammenhang mit weiteren Nachrichten gebracht werden muss, KÖNNEN die Nachrichten miteinander verknüpft werden. Neue Nachrichten MÜSSEN auf die bereits zuvor existierenden Nachrichten zeigen.
+
Communication.subject
+
Bedeutung: Patient-Referenz als Aussage für welche Patienten die Communication verfasst wird
+
Hinweis: Ein Patientenbezug muss stets gegeben sein, soweit möglich.
+
Communication.recipient
+
Bedeutung: Empfänger der Communication
+
Hinweis: Für Practitioner und HealthcareService muss Reference.reference angegeben werden. Für weitere Ressourcen MUSS ein Reference.display angegeben werden.
+
Communication.sender
+
Hinweis: Für Patient, Practitioner und HealthcareService muss Reference.reference angegeben werden. Für weitere Ressourcen MUSS ein Reference.display angegeben werden.
+
Communication.payload
+
Bedeutung: Inhalt der Communication
+
Hinweis: Ein bestätigungsrelevantes System MUSS sowohl Freitext, als auch base64-kodierte Inhalte unterstützten. Falls strukturierte Metadaten über das zu übermittelnde Dokument verfügbar sind, KANN ein bestätigungsrelevantes System es als DocumentReference-Ressource ablegen. Für die Anlage einer solchen Ressource wird auf das ISiK Dokumentenaustausch verwiesen. Die erzeugte Ressource SOLL anschließend durch das bestätigungsrelevante System unter dem contentReference-Element als Referenz angegeben werden. Jegliche Funktionalität bezogen auf das Modul Dokumentenaustausch ist nicht bestätigungsrelevant. Dokumente welche als Attachment angegeben werden, MÜSSEN in ihrer URL auf eine ISiKBinary Ressource verweisen. Diese Binary-Ressource SOLL per CREATE-Interaktion angelegt werden im empfangenden System.
+
+
Interaktionen
+
Für die Ressource Communication MÜSSEN die REST-Interaktionen "READ", "CREATE", "UPDATE" implementiert werden.
A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
Definition
A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s).
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
app-3: Only proposed or cancelled appointments can be missing start/end dates (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-2: Either start and end are specified, or neither start.exists() = end.exists()
ISiK-app-1: Der Endzeitpunkt eines Termins MUSS nach dem Startzeitpunkt liegen start <= end
There are no (further) constraints on this element
Element id
Appointment.meta
Short description
Metadata about the resource
Definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
There are no (further) constraints on this element
Element id
Appointment.meta.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Appointment.meta.versionId
Short description
Version specific identifier
Definition
The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
+
Comments
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
There are no (further) constraints on this element
Element id
Appointment.meta.lastUpdated
Short description
When the resource version last changed
Definition
When the resource last changed - e.g. when the version changed.
+
Comments
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
There are no (further) constraints on this element
Element id
Appointment.meta.source
Short description
Identifies where the resource comes from
Definition
A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
+
Comments
In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.
+
This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
There are no (further) constraints on this element
Element id
Appointment.meta.security
Short description
Security Labels applied to this resource
Definition
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
+
Comments
The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
+
Comments
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
+
Comments
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
There are no (further) constraints on this element
Element id
Appointment.implicitRules
Short description
A set of rules under which this content was created
Definition
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
+
Comments
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
There are no (further) constraints on this element
Element id
Appointment.language
Short description
Language of the resource content
Definition
The base language in which the resource is written.
+
Comments
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
There are no (further) constraints on this element
Element id
Appointment.text
Short description
Text summary of the resource, for human interpretation
Alternate names
narrative, html, xhtml, display
Definition
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
+
Comments
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
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.
+
Comments
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Conditional Must Support - Einschränkung der übergreifenden MS-Definition: Falls ein bestätigungsrelevantes System das ISiK-Profil ISiKNachricht implementiert, MUSS das System auch dieses Element unterstützten. Andernfalls KANN das System dieses Element unterstützen.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Appointment.modifierExtension
Short description
Extensions that cannot be ignored
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Appointment.identifier
Short description
External Ids for this item
Definition
This records identifiers associated with this appointment concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
The overall status of the Appointment. Each of the participants has their own participation status which indicates their involvement in the process, however this status indicates the shared status.
+
Comments
If the Appointment's status is "cancelled" then all participants are expected to have their calendars released for the appointment period, and as such any Slots that were marked as BUSY can be re-set to FREE.
+
This element is labeled as a modifier because the status contains the code entered-in-error that mark the Appointment as not currently valid.
The coded reason for the appointment being cancelled
Definition
The coded reason for the appointment being cancelled. This is often used in reporting/billing/futher processing to determine if further actions are required, or specific fees apply.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Appointment.serviceCategory
Short description
A broad categorization of the service that is to be performed during this appointment
Definition
A broad categorization of the service that is to be performed during this appointment.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Appointment.serviceType
Short description
The specific service that is to be performed during this appointment
Definition
The specific service that is to be performed during this appointment.
+
Comments
For a provider to provider appointment the code "FOLLOWUP" may be appropriate, as this is expected to be discussing some patient that was seen in the past.
The specialty of a practitioner that would be required to perform the service requested in this appointment
Definition
The specialty of a practitioner that would be required to perform the service requested in this appointment.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
The specialty of a practitioner that would be required to perform the service requested in this appointment
Definition
The specialty of a practitioner that would be required to perform the service requested in this appointment.
+
Comments
Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024).
The specialty of a practitioner that would be required to perform the service requested in this appointment
Definition
The specialty of a practitioner that would be required to perform the service requested in this appointment.
+
Comments
Dieses ValueSet KANN über ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verknüpft werden und darüber ggf. die Integration von Systemen erleichtern.
There are no (further) constraints on this element
Element id
Appointment.appointmentType
Short description
The style of appointment or patient that has been booked in the slot (not service type)
Definition
The style of appointment or patient that has been booked in the slot (not service type).
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Appointment.reasonCode
Short description
Coded reason this appointment is scheduled
Definition
The coded reason that this appointment is being scheduled. This is more clinical than administrative.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Appointment.reasonReference
Short description
Reason the appointment is to take place (resource)
Definition
Reason the appointment has been scheduled to take place, as specified using information from another resource. When the patient arrives and the encounter begins it may be used as the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Appointment.priority
Short description
Used to make informed decisions if needing to re-prioritize
Definition
The priority of the appointment. Can be used to make informed decisions if needing to re-prioritize appointments. (The iCal Standard specifies 0 as undefined, 1 as highest, 9 as lowest priority).
+
Comments
Seeking implementer feedback on this property and how interoperable it is.
+
Using an extension to record a CodeableConcept for named values may be tested at a future connectathon.
There are no (further) constraints on this element
Element id
Appointment.priority.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Appointment.description
Short description
Shown on a subject line in a meeting request, or appointment list
Definition
The brief description of the appointment as would be shown on a subject line in a meeting request, or appointment list. Detailed or expanded information should be put in the comment field.
+
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
There are no (further) constraints on this element
Element id
Appointment.supportingInformation
Short description
Additional information to support the appointment
Definition
Additional information to support the appointment provided when making the appointment.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Appointment.start
Short description
When appointment is to take place
Definition
Date/Time that the appointment is to take place.
+
Comments
Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required
There are no (further) constraints on this element
Element id
Appointment.end
Short description
When appointment is to conclude
Definition
Date/Time that the appointment is to conclude.
+
Comments
Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required
There are no (further) constraints on this element
Element id
Appointment.minutesDuration
Short description
Can be less than start/end (e.g. estimate)
Definition
Number of minutes that the appointment is to take. This can be less than the duration between the start and end times. For example, where the actual time of appointment is only an estimate or if a 30 minute appointment is being requested, but any time would work. Also, if there is, for example, a planned 15 minute break in the middle of a long appointment, the duration may be 15 minutes less than the difference between the start and end.
+
Comments
32 bit number; for values larger than this, use decimal
The slots from the participants' schedules that will be filled by the appointment.
+
Comments
Zur Referenzierung auf eine Slot-Ressource MUSS eine Reference.reference mit einer URL verwendet werden. Das Termin-Repository muss so gestaltet sein, dass es aus Perspektive des Clients nur eine Service-BaseUrl gibt.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Appointment.slot.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Appointment.slot.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Appointment.slot.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Appointment.slot.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Appointment.slot.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Appointment.created
Short description
The date that this appointment was initially created
Definition
The date that this appointment was initially created. This could be different to the meta.lastModified value on the initial entry, as this could have been before the resource was created on the FHIR server, and should remain unchanged over the lifespan of the appointment.
+
Comments
This property is required for many use cases where the age of an appointment is considered in processing workflows for scheduling and billing of appointments.
Im ISiK Kontext sollte dieses Feld zur internen Kommunikation zwischen Leistungserbringern verwendet werden, z.B. für interne Notizen rund um den Termin.
+
Es gilt weiterhin die Semantik des Elements nach FHIR-Kernspezifikation:
+
'Additional text to aid in facilitating the appointment. For instance, a comment might be, 'patient should proceed immediately to infusion room upon arrival'
+
Where this is a planned appointment and the start/end dates are not set then this field can be used to provide additional guidance on the details of the appointment request, including any restrictions on when to book it.'
Detailed information and instructions for the patient
Definition
While Appointment.comment contains information for internal use, Appointment.patientInstructions is used to capture patient facing information about the Appointment (e.g. please bring your referral or fast from 8pm night before).
+
Comments
Dieses Feld sollte im Kontext von ISIK verwendet werden für die Kommunikation im Sinne der Definition der FHIR-Kernspezifikation - sowohl von Systemseite (administrativ) als auch von Seiten des medizinischen Fachpersonals.
+
Beispiel für eine Nachricht: 'Bitte nüchtern erscheinen' etc.
+
Es gilt weiterhin der Hinweis der FHIR Kernspezifikation:
+'Note that FHIR strings SHALL NOT exceed 1MB in size'
There are no (further) constraints on this element
Element id
Appointment.basedOn
Short description
The service request this appointment is allocated to assess
Alternate names
incomingReferral
Definition
The service request this appointment is allocated to assess (e.g. incoming referral or procedure request).
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Appointment.participant.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Appointment.participant.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Appointment.participant.actor
Short description
Person, Location/HealthcareService or Device
Definition
A Person, Location/HealthcareService or Device that is participating in the appointment.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
ical: ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
There are no (further) constraints on this element
Element id
Appointment.participant.actor.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Appointment.participant.actor.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Appointment.participant.actor.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Appointment.participant.actor.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Appointment.participant.actor.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Appointment.participant.required
Short description
required | optional | information-only
Definition
Whether this participant is required to be present at the meeting. This covers a use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.
+
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
There are no (further) constraints on this element
Element id
Appointment.participant.period
Short description
Participation period of the actor
Definition
Participation period of the actor.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Appointment.participant:AkteurPatient.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
A Person, Location/HealthcareService or Device that is participating in the appointment.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
ical: ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Appointment.participant:AkteurPatient.actor.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Appointment.participant:AkteurPatient.required
Short description
required | optional | information-only
Definition
Whether this participant is required to be present at the meeting. This covers a use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.
+
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
There are no (further) constraints on this element
Element id
Appointment.participant:AkteurPatient.period
Short description
Participation period of the actor
Definition
Participation period of the actor.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
A Person, Location/HealthcareService or Device that is participating in the appointment.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
ical: ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Whether this participant is required to be present at the meeting. This covers a use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.
+
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
A Person, Location/HealthcareService or Device that is participating in the appointment.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
ical: ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Whether this participant is required to be present at the meeting. This covers a use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.
+
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Appointment.requestedPeriod
Short description
Potential date/time interval(s) requested to allocate the appointment within
Definition
A set of date ranges (potentially including times) that the appointment is preferred to be scheduled within.
+
The duration (usually in minutes) could also be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time. However, in other situations the duration may be calculated by the scheduling system.
+
Comments
This does not introduce a capacity for recurring appointments.
Hinweis: Die Kardinalität von participant.actor.display und das MS-Flag von participant.status wird an die Slices vererbt und diese sind entsprechend zu implementieren.
+
Folgende FHIRPath-Constraints sind im Profil zu beachten:
+
key
severity
human
expression
ISiK-app-1
error
Der Endzeitpunkt eines Termins MUSS nach dem Startzeitpunkt liegen
Hinweis: Angabe, ob der Termin durch einen externen Termin Requestor eingestellt wurde. Falls das Datenobjekt dauerhaft in das Termin Repository gespeichert wird, KANN der Tag entfernt werden. Für die weitere Prozesssteuerung kann eine Unterscheidung, ob es sich um einen intern oder extern erstellten Termin handelt, notwendig sein, sodass aus Gründen der Nachvollziehbarkeit der Tag bestehen bleiben sollte. Des Weiteren gelten die Vorgaben des ISiK Basismoduls zur CREATE-Interaktion.
+
Appointment.extension:Nachricht
+
Bedeutung: Kommunikation mit dem Patienten
+
Hinweis: Für die Kommunikation mit dem Patienten sind Communication-Ressourcen zu verwenden. Für den Termin relevante Kommentare oder Anhänge MÜSSEN angegeben werden. Zudem kann die Communication-Ressource auch für die Kommunikation zwischen Leistungserbringer verwendet werden. Es ist zu beachten, dass in diesem Fall Kommentare vor der Herausgabe an die Patient:in gefiltert werden sollten.
+
Appointment.extension:replaces
+
Bedeutung: Angabe eines abgesagten / verschobenen Termins
+
Hinweis: Im Falle, dass per $book-Operation ein verschobener / abgesagter Termin angegeben wird, MUSS dieser für die Rückverfolgbarkeit referenziert werden.
+
Appointment.status
+
Bedeutung: Differenzierung zwischen Terminwunsch und gebuchten Termin
+
Hinweis: Ein Termin Requestor kann im Status entsprechend wählen, sodass der Termin als Terminwunsch zu interpretieren ist. Nachdem der Termin bestätigt wurde, ist der Terminstatus durch das Termin-Repository anzupassen.
+
Alle Statuswerte MÜSSEN durch ein bestätigungsrelevantes System unterstützt werden, insbesondere der Status "proposed" und "booked".
+
Appointment.cancelationReason
+
Bedeutung: Grund für die Absage eines Termins
+
Hinweis: Eine minimale Kodierung MUSS mittels des vorgeschlagenen Bindings vorliegen. Differenzierungen mit feinerer Granularität können durch weitere Codings erfolgen.
+
Appointment.serviceType
+
Bedeutung: Kodierung der Behandlungsleistung des Termins
+
Hinweis: Dies SOLL der Kodierung des serviceType eines Schedules entsprechen, der innerhalb des Termins gebucht wird. Ein Termin-Repository SOLL einen Termin abweisen, falls unbekannte Kodierungen in .serviceType durch den Termin-Requestor übermittelt werden, sodass ein Termin-Repository sicherstellen kann, dass alle Ressourcen für die Behandlungsleistung(en) bereitgestellt werden können. Hierzu ist eine Interpretation der Behandlungsleistung notwendig. Ein Termin KANN für mehrere Behandlungsleistungen gebucht werden, falls dies durch die Fachlogik des Termin-Repositories unterstüzt wird.
+
Appointment.specialty
+
Bedeutung: Kodierung der Fachrichtung des Termins
+
Hinweis: Sofern aus den auf der Appointment-Ressource aufsetzenden Anwendungsfällen eine weitere Verarbeitung der Ressource durch einen menschlichen Nutzer nicht ausgeschlossen werden kann, MUSS das bestätigungsrelevante System mit dem Termin verbundenen Ressourcen (insb. Appointment.slot, Appointment.slot.schedule, Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor) oder aus dem spezifischen Kontext verfügbare Informationen auswerten und das Element Appointment.specialty mit einem sinnvollen Wert kodieren (eine Ausnahme bildet hier zum Beispiel die fachrichtungs-unabhängige Terminplanung durch krankenhausinterne, zentrale Organisationseinheiten).
+Insbesondere ist die Kodierung der Fachrichtung des Termins notwendig im Kontext der Bereitstellung einer graphischen Oberfläche, wie sie Endnutzenden in einem Zuweiserportal/Patientenportal zur Ansicht gebracht wird.
+
Appointment.priority.extension:Priority
+
Bedeutung: Kodierte Angabe der Priorität des Termins
+
Hinweis: Anstelle der numerischen Priorität MUSS in ISiK eine kodierte Priorität angegeben werden.
+
Appointment.start
+
Bedeutung: Startzeitpunkt des Termins
+
Hinweis: Sofern der Termin an einen Slot gebunden ist, SOLL der Startzeitpunkt des Termins dem Startzeitpunkt des ersten Slots des Termins entsprechen.
+
Appointment.end
+
Bedeutung: Endzeitpunkt des Termins
+
Hinweis: Sofern der Termin an einen Slot gebunden ist, SOLL der Endzeitpunkt des Termins dem Endzeitpunkt des letzten Slots des Termins entsprechen.
+
Appointment.slot
+
Bedeutung: Referenzierung der Slots für die Verknüpfung des Termins mit einem Schedule
+
Hinweis: Die Referenzierung des Schedules kann durch einen oder mehrere Slots erfolgen. Es kann keine Reihenfolge durch die Angabe der Slots abgeleitet werden.
+
Hinweis: In der Vergangenheit liegende Slots, welche nicht verknüpft wurden, dürfen nicht mehr abrufbar sein. Jegliche andere Slots müssen auch per id, herausgegeben werden. Sobald die id einmalig per Search herausgeben wurde, müssen diese gleichbleibend abrufbar sein.
+
Appointment.patientInstruction
+
Bedeutung: Handlungsanweisungen für die Patienten in Vorbereitung auf den Termin
+
Appointment.participant
+
Bedeutung: TeilnehmerInnen des Termins
+
Hinweis: Mindestens eine Patient-Referenz MUSS angegeben werden. Dies MUSS durch das Termin-Repository während der Buchung des Termins geprüft werden. Weitere Leistungserbringer KÖNNEN angegeben werden.
+
+
Interaktionen
+
Für die Ressource Appointment MÜSSEN die REST-Interaktionen "READ" und "PATCH" implementiert werden.
Der Suchparameter "service-type" MUSS unterstützt werden:
+
Beispiele:
+
GET [base]/Appointment?service-type=http://example.org/fhir/CodeSystem/ScheduleServiceType|CT
+
Anwendungshinweise: Bei einer Suche mit dem ":not"-Modifier MÜSSEN Ressourcen, die keinen Wert für "Appointment.serviceType" enthalten, im Suchergebnis enthalten sein. Bei einer Suche ohne den ":not"-Modifier DÜRFEN Ressourcen, die keinen Wert für "Appointment.serviceType" enthalten, NICHT im Suchergebnis enthalten sein. Weitere Informationen zur Suche nach "Appointment.serviceType" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
+
+
Der Suchparameter "specialty" MUSS unterstützt werden:
+
Beispiele:
+
GET [base]/Appointment?specialty=urn:oid:1.2.276.0.76.5.114|535
+
Anwendungshinweise: Bei einer Suche mit dem ":not"-Modifier MÜSSEN Ressourcen, die keinen Wert für "Appointment.specialty" enthalten, im Suchergebnis enthalten sein. Bei einer Suche ohne den ":not"-Modifier DÜRFEN Ressourcen, die keinen Wert für "Appointment.specialty" enthalten, NICHT im Suchergebnis enthalten sein. Weitere Informationen zur Suche nach "Appointment.specialty" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
+
+
Der Suchparameter "date" MUSS unterstützt werden:
+
Beispiele:
+
GET [base]/Appointment?date=2022-12-10T09:00:00Z
+
Anwendungshinweise: Die Suche wird gegen das Element "Appointment.start" ausgewertet. Weitere Informationen zur Suche nach "Appointment.start" finden sich in der FHIR-Basisspezifikation - Abschnitt "Date Search".
Das Datenobjekt ISiKKontaktMitGesundheitseinrichtung dient der Verknüpfung des ISiK-Basis-Encounters (ISiKKontaktGesundheitseinrichtung) mit einem Termin (Appointment) und - darauf aufbauend - der Dokumentenkommunikation.
+
Die Anforderung dieser Verknüpfung stammt aus dem Szenario der Dokument-Übertragung zwischen Patientenportal und krankenhaus-internem Primärsystem (KIS): Dokumente liegen bei Termin-Buchung erst im Patientenportal (im Appointment) vor und werden erst mit Anlage des Encounters in das KIS (etc.) übermittelt. Dazu muss das Appointment mit dem neu angelegten Encounter verknüpft werden, um die Dokumente aus dem Patientenportal darüber zuzuordnen.
+
Hieraus folgt, dass das Datenobjekt nur relevant ist, falls das bestätigungsrelevante System das Datenobjekt ISiKKontaktGesundheitseinrichtung sowie ISiKTermin implementiert. Zu Beginn des Termins sollte das System die Verknüpfung zwischen Encounter und Appointment herstellen. Ausgenommen hiervon sind Termine, die nicht stattfinden, da für diese in der Regel keine Encounter angelegt werden.
There are no (further) constraints on this element
Element id
Encounter
Short description
An interaction during which services are provided to the patient
Alternate names
Visit
Definition
An interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
ISiK-enc-1: Abgeschlossene, ambulante Kontakte sollten einen Start-Zeitpunkt angeben status = 'finished' and class = 'AMB' implies period.start.exists()
ISiK-enc-2: Abgeschlossene, stationäre Kontakte sollten einen Start- und End-Zeitpunkt angeben status = 'finished' and class = 'IMP' implies period.start.exists() and period.end.exists()
ISiK-enc-3: Geplante Kontakte sollten keinen Start- oder End-Zeitpunkt angeben status = 'planned' implies period.exists().not()
ISiK-enc-4: Geplante Kontakte sollten die Extensions für den geplanten Start- oder End-Zeitpunkt verwenden status = 'planned' implies extension.where(url = 'http://hl7.org/fhir/5.0/StructureDefinition/extension-Encounter.plannedStartDate').exists()
ISiK-enc-5: In-Durchführung befindliche Kontakte sollten einen Start-Zeitpunkt angeben status = 'in-progress' implies period.start.exists()
ISiK-enc-6: Kontakte mit Abwesenheitsstatus sollten einen Start-Zeitpunkt angeben status = 'onleave' implies period.start.exists()
ISiK-enc-7: Kontakte mit unbekannten Status sollten einen Start-Zeitpunkt angeben status = 'unknown' implies period.start.exists()
ISiK-enc-8: Die Rolle der assoziierten Diagnose(n) darf nicht 'Billing' sein diagnosis.use.all(coding.code != 'billing')
There are no (further) constraints on this element
Element id
Encounter.meta
Short description
Metadata about the resource
Definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
There are no (further) constraints on this element
Element id
Encounter.implicitRules
Short description
A set of rules under which this content was created
Definition
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
+
Comments
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
There are no (further) constraints on this element
Element id
Encounter.language
Short description
Language of the resource content
Definition
The base language in which the resource is written.
+
Comments
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
There are no (further) constraints on this element
Element id
Encounter.text
Short description
Text summary of the resource, for human interpretation
Alternate names
narrative, html, xhtml, display
Definition
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
+
Comments
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
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.
+
Comments
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
There are no (further) constraints on this element
Element id
Encounter.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.extension:Aufnahmegrund
Short description
Optional Extensions Element
Alternate names
extensions, user content
Definition
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.extension:Aufnahmegrund.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Source of the definition for the extension code - a logical name or a URL.
+
Comments
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Source of the definition for the extension code - a logical name or a URL.
+
Comments
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Source of the definition for the extension code - a logical name or a URL.
+
Comments
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
There are no (further) constraints on this element
Element id
Encounter.extension:Aufnahmegrund.url
Short description
identifies the meaning of the extension
Definition
Source of the definition for the extension code - a logical name or a URL.
+
Comments
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
There are no (further) constraints on this element
Element id
Encounter.extension:plannedStartDate
Short description
Optional Extensions Element
Alternate names
extensions, user content
Definition
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.extension:plannedEndDate
Short description
Optional Extensions Element
Alternate names
extensions, user content
Definition
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.modifierExtension
Short description
Extensions that cannot be ignored
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Encounter.identifier:Aufnahmenummer.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.identifier:Aufnahmenummer.type
Short description
Description of identifier
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
+
Requirements
Allows users to make use of identifiers when the identifier system is not known.
+
Comments
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.identifier:Aufnahmenummer.type.coding
Short description
Code defined by a terminology system
Definition
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
The identification of the code system that defines the meaning of the symbol in the code.
+
Requirements
Need to be unambiguous about the source of the definition of the symbol.
+
Comments
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 reference to some definition that establishes the system clearly and unambiguously.
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.
+
Comments
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).
+
Requirements
Need to refer to a particular code in the system.
+
Comments
Note that FHIR strings SHALL NOT exceed 1MB in size
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
+
Requirements
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.
+
Comments
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.
There are no (further) constraints on this element
Element id
Encounter.identifier:Aufnahmenummer.type.text
Short description
Plain text representation of the concept
Definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
+
Requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
+
Comments
Very often the text is the same as a displayName of one of the codings.
There are no (further) constraints on this element
Element id
Encounter.identifier:Aufnahmenummer.system
Short description
The namespace for the identifier value
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
+
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
There are no (further) constraints on this element
Element id
Encounter.identifier:Aufnahmenummer.value
Short description
The value that is unique
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
+
Comments
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
There are no (further) constraints on this element
Element id
Encounter.identifier:Aufnahmenummer.period
Short description
Time period when id is/was valid for use
Definition
Time period during which identifier is/was valid for use.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Encounter.identifier:Aufnahmenummer.assigner
Short description
Organization that issued id (may be just text)
Definition
Organization that issued/manages the identifier.
+
Comments
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
There are no (further) constraints on this element
Element id
Encounter.statusHistory
Short description
List of past encounter statuses
Definition
The status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.
+
Comments
The current status is always found in the current version of the resource, not the status history.
There are no (further) constraints on this element
Element id
Encounter.statusHistory.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.statusHistory.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.statusHistory.period
Short description
The time that the episode was in the specified status
Definition
The time that the episode was in the specified status.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Encounter.class
Short description
Classification of patient encounter
Definition
Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.
+
Comments
Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.
There are no (further) constraints on this element
Element id
Encounter.classHistory
Short description
List of past encounter classes
Definition
The class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transitions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kind of discharge from emergency to inpatient.
There are no (further) constraints on this element
Element id
Encounter.classHistory.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.classHistory.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.
There are no (further) constraints on this element
Element id
Encounter.classHistory.period
Short description
The time that the episode was in the specified class
Definition
The time that the episode was in the specified class.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Encounter.serviceType
Short description
Specific type of service
Definition
Broad categorization of the service that is to be provided (e.g. cardiology).
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Encounter.serviceType.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.serviceType.coding
Short description
Code defined by a terminology system
Definition
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
There are no (further) constraints on this element
Element id
Encounter.serviceType.text
Short description
Plain text representation of the concept
Definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
+
Requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
+
Comments
Very often the text is the same as a displayName of one of the codings.
There are no (further) constraints on this element
Element id
Encounter.priority
Short description
Indicates the urgency of the encounter
Definition
Indicates the urgency of the encounter.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Encounter.subject
Short description
The patient or group present at the encounter
Alternate names
patient
Definition
The patient or group present at the encounter.
+
Comments
While the encounter is always about the patient, the patient might not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.subject.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.subject.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Encounter.subject.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Encounter.subject.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Encounter.subject.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Encounter.episodeOfCare
Short description
Episode(s) of care that this encounter should be recorded against
Definition
Where a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.basedOn
Short description
The ServiceRequest that initiated this encounter
Alternate names
incomingReferral
Definition
The request this encounter satisfies (e.g. incoming referral or procedure request).
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.participant.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.participant.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.participant.type
Short description
Role of participant in encounter
Definition
Role of participant in encounter.
+
Comments
The participant type indicates how an individual participates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.
There are no (further) constraints on this element
Element id
Encounter.participant.period
Short description
Period of time during the encounter that the participant participated
Definition
The period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Encounter.participant.individual
Short description
Persons involved in the encounter other than the patient
Definition
Persons involved in the encounter other than the patient.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.appointment
Short description
The appointment that scheduled this encounter
Definition
The appointment that scheduled this encounter.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.period.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.period.end
Short description
End time with inclusive boundary, if not ongoing
Definition
The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
+
Comments
The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
+
Meaning when missing
If the end of the period is missing, it means that the period is ongoing
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
qty-3: If a code for the unit is present, the system SHALL also be present code.empty() or system.exists()
drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM. code.exists() implies ((system = %ucum) and value.exists())
Mappings
rim: n/a
v2: SN (see also Range) or CQ
rim: PQ, IVL<PQ>, MO, CO, depending on the values
rim: PQ, IVL<PQ> depending on the values
workflow: Event.occurrence[x]
v2: (PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes
There are no (further) constraints on this element
Element id
Encounter.reasonCode
Short description
Coded reason the encounter takes place
Alternate names
Indication, Admission diagnosis
Definition
Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
+
Comments
For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CE/CNE/CWE
rim: CD
orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
workflow: Event.reasonCode
w5: FiveWs.why[x]
v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
There are no (further) constraints on this element
Element id
Encounter.reasonReference
Short description
Reason the encounter takes place (reference)
Alternate names
Indication, Admission diagnosis
Definition
Reason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
+
Comments
For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonCode
w5: FiveWs.why[x]
v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
There are no (further) constraints on this element
Element id
Encounter.diagnosis.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Reason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.
+
Comments
For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
workflow: Event.reasonReference
w5: FiveWs.why[x]
v2: Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.condition.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.condition.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.condition.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.condition.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Encounter.diagnosis.condition.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.use
Short description
Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
Definition
Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …).
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.use.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.use.coding
Short description
Code defined by a terminology system
Definition
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.use.coding:Diagnosetyp
Short description
Code defined by a terminology system
Definition
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.use.coding:DiagnosesubTyp
Short description
Code defined by a terminology system
Definition
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
There are no (further) constraints on this element
Element id
Encounter.diagnosis.use.text
Short description
Plain text representation of the concept
Definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
+
Requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
+
Comments
Very often the text is the same as a displayName of one of the codings.
There are no (further) constraints on this element
Element id
Encounter.account
Short description
The set of accounts that may be used for billing for this Encounter
Definition
The set of accounts that may be used for billing for this Encounter.
+
Comments
The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.account.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.account.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Encounter.account.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Encounter.account.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Encounter.account.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Encounter.hospitalization.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.hospitalization.extension:Wahlleistung
Short description
Optional Extensions Element
Alternate names
extensions, user content
Definition
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.hospitalization.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Encounter.hospitalization.origin
Short description
The location/organization from which the patient came before admission
Definition
The location/organization from which the patient came before admission.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.hospitalization.admitSource
Short description
From where patient was admitted (physician referral, transfer)
Definition
From where patient was admitted (physician referral, transfer).
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Encounter.hospitalization.reAdmission
Short description
The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission
Definition
Whether this hospitalization is a readmission and why if known.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Encounter.hospitalization.dietPreference
Short description
Diet preferences reported by the patient
Definition
Diet preferences reported by the patient.
+
Requirements
Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.
+
Comments
For example, a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).
There are no (further) constraints on this element
Element id
Encounter.hospitalization.specialCourtesy
Short description
Special courtesies (VIP, board member)
Definition
Special courtesies (VIP, board member).
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Encounter.hospitalization.specialArrangement
Short description
Wheelchair, translator, stretcher, etc.
Definition
Any special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Encounter.hospitalization.destination
Short description
Location/organization to which the patient is discharged
Definition
Location/organization to which the patient is discharged.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.hospitalization.dischargeDisposition
Short description
Category or kind of location after discharge
Definition
Category or kind of location after discharge.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Optional Extension Element - found in all resources.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
A reference to a code defined by a terminology system.
+
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
+
Comments
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
+
Requirements
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
+
Comments
Very often the text is the same as a displayName of one of the codings.
There are no (further) constraints on this element
Element id
Encounter.location
Short description
List of locations where the patient has been
Definition
List of locations where the patient has been during this encounter.
+
Comments
Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".
There are no (further) constraints on this element
Element id
Encounter.location.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location.location
Short description
Location the encounter takes place
Definition
The location where the encounter takes place.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.location.status
Short description
planned | active | reserved | completed
Definition
The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.
+
Comments
When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.
There are no (further) constraints on this element
Element id
Encounter.location.physicalType
Short description
The physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Definition
This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.
+
Comments
This information is de-normalized from the Location resource to support the easier understanding of the encounter resource and processing in messaging or query.
+
There may be many levels in the hierachy, and this may only pic specific levels that are required for a specific usage scenario.
There are no (further) constraints on this element
Element id
Encounter.location.period
Short description
Time period during which the patient was present at the location
Definition
Time period during which the patient was present at the location.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer
Short description
List of locations where the patient has been
Definition
List of locations where the patient has been during this encounter.
+
Comments
Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.location
Short description
Location the encounter takes place
Definition
The location where the encounter takes place.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.location.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.location.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.location.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.location.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.location.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.status
Short description
planned | active | reserved | completed
Definition
The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.
+
Comments
When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.physicalType
Short description
The physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Definition
This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.
+
Comments
Die Kodierung in diesem Slice entstammt folgendem Valueset - gelistet unter .location.(All slices.)physicalType: https://gematik.de/fhir/isik/ValueSet/ISiKLocationPhysicalType
There are no (further) constraints on this element
Element id
Encounter.location:Zimmer.period
Short description
Time period during which the patient was present at the location
Definition
Time period during which the patient was present at the location.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Encounter.location:Bettenstellplatz
Short description
List of locations where the patient has been
Definition
List of locations where the patient has been during this encounter.
+
Comments
Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".
There are no (further) constraints on this element
Element id
Encounter.location:Bettenstellplatz.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location:Bettenstellplatz.location
Short description
Location the encounter takes place
Definition
The location where the encounter takes place.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Encounter.location:Bettenstellplatz.location.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Encounter.location:Bettenstellplatz.status
Short description
planned | active | reserved | completed
Definition
The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.
+
Comments
When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.
There are no (further) constraints on this element
Element id
Encounter.location:Bettenstellplatz.physicalType
Short description
The physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Definition
This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.
+
Comments
Die Kodierung in diesem Slice entstammt folgendem Valueset - gelistet unter .location.(All slices.)physicalType: https://gematik.de/fhir/isik/ValueSet/ISiKLocationPhysicalType
There are no (further) constraints on this element
Element id
Encounter.location:Bettenstellplatz.period
Short description
Time period during which the patient was present at the location
Definition
Time period during which the patient was present at the location.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Encounter.location:Station
Short description
List of locations where the patient has been
Definition
List of locations where the patient has been during this encounter.
+
Comments
Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".
There are no (further) constraints on this element
Element id
Encounter.location:Station.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location:Station.modifierExtension
Short description
Extensions that cannot be ignored even if unrecognized
Alternate names
extensions, user content, modifiers
Definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location:Station.location
Short description
Location the encounter takes place
Definition
The location where the encounter takes place.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.location:Station.location.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.location:Station.location.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Encounter.location:Station.location.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Encounter.location:Station.location.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Encounter.location:Station.location.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Encounter.location:Station.status
Short description
planned | active | reserved | completed
Definition
The status of the participants' presence at the specified location during the period specified. If the participant is no longer at the location, then the period will have an end date/time.
+
Comments
When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.
There are no (further) constraints on this element
Element id
Encounter.location:Station.physicalType
Short description
The physical type of the location (usually the level in the location hierachy - bed room ward etc.)
Definition
This will be used to specify the required levels (bed/ward/room/etc.) desired to be recorded to simplify either messaging or query.
+
Comments
Die Kodierung in diesem Slice entstammt folgendem Valueset - gelistet unter .location.(All slices.)physicalType: https://gematik.de/fhir/isik/ValueSet/ISiKLocationPhysicalType
There are no (further) constraints on this element
Element id
Encounter.location:Station.period
Short description
Time period during which the patient was present at the location
Definition
Time period during which the patient was present at the location.
+
Comments
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
+
Period is not used for a duration (a measure of elapsed time). See Duration.
There are no (further) constraints on this element
Element id
Encounter.serviceProvider
Short description
The organization (facility) responsible for this encounter
Definition
The organization that is primarily responsible for this Encounter's services. This MAY be the same as the organization on the Patient record, however it could be different, such as if the actor performing the services was from an external organization (which may be billed seperately) for an external consultation. Refer to the example bundle showing an abbreviated set of Encounters for a colonoscopy.
+
Comments
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Encounter.serviceProvider.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Encounter.serviceProvider.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Encounter.serviceProvider.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Encounter.serviceProvider.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Encounter.serviceProvider.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
Für die Ressource Encounter MUSS die REST-Interaktion "READ" implementiert werden:
+
Der Suchparameter "appointment" MUSS unterstützt werden:
+
Beispiele:
+
+```GET [base]/Encounter?appointment=Appointment/123```
+
+Anwendungshinweise: Weitere Informationen zur Suche nach "appointment" finden sich in der [FHIR-Basisspezifikation - Abschnitt "Reference Search"](https://www.hl7.org/fhir/R4/search.html#reference).
+
Die Slot-Ressource repräsentiert die Verbindung eines Termins (Appointment) und den dazugehörigen Ressourcen (z.B. HealthcareService, Device, Practitioner). Für diese Ressourcen können separate Kalender (Schedules) verwaltet werden. Der Slot agiert als Verbindungsstück zwischen diesen Ressourcen.
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-6: A resource should have narrative for robust management text.`div`.exists()
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
ISiK-slot-1: Der Endzeitpunkt eines Terminsblocks MUSS nach dem Startzeitpunkt liegen start <= end
Mappings
rim: Entity. Role, or Act
rim: n/a
ical: (refer to the Availability resource for the header mapping details)
There are no (further) constraints on this element
Element id
Slot.meta
Short description
Metadata about the resource
Definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
There are no (further) constraints on this element
Element id
Slot.implicitRules
Short description
A set of rules under which this content was created
Definition
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
+
Comments
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
There are no (further) constraints on this element
Element id
Slot.language
Short description
Language of the resource content
Definition
The base language in which the resource is written.
+
Comments
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
There are no (further) constraints on this element
Element id
Slot.text
Short description
Text summary of the resource, for human interpretation
Alternate names
narrative, html, xhtml, display
Definition
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
+
Comments
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
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.
+
Comments
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
There are no (further) constraints on this element
Element id
Slot.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Slot.modifierExtension
Short description
Extensions that cannot be ignored
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
+
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
+
Requirements
Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Slot.serviceCategory
Short description
A broad categorization of the service that is to be performed during this appointment
Definition
A broad categorization of the service that is to be performed during this appointment.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Slot.serviceType
Short description
The type of appointments that can be booked into this slot (ideally this would be an identifiable service - which is at a location, rather than the location itself). If provided then this overrides the value provided on the availability resource
Definition
The type of appointments that can be booked into this slot (ideally this would be an identifiable service - which is at a location, rather than the location itself). If provided then this overrides the value provided on the availability resource.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Slot.specialty
Short description
The specialty of a practitioner that would be required to perform the service requested in this appointment
Definition
The specialty of a practitioner that would be required to perform the service requested in this appointment.
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
There are no (further) constraints on this element
Element id
Slot.appointmentType
Short description
The style of appointment or patient that may be booked in the slot (not service type)
Definition
The style of appointment or patient that may be booked in the slot (not service type).
+
Comments
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
The schedule resource that this slot defines an interval of status information
Definition
The schedule resource that this slot defines an interval of status information.
+
Comments
Zur Referenzierung auf eine Schedule-Ressource MUSS eine Reference.reference mit einer URL verwendet werden. Das Termin-Repository muss so gestaltet sein, dass es aus Perspektive des Clients nur eine Service-BaseUrl gibt.
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ref-1: SHALL have a contained resource if a local reference is provided reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
Mappings
rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
There are no (further) constraints on this element
Element id
Slot.schedule.extension
Short description
Additional content defined by implementations
Alternate names
extensions, user content
Definition
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
+
Comments
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
There are no (further) constraints on this element
Element id
Slot.schedule.reference
Short description
Literal reference, Relative, internal or absolute URL
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
+
Comments
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
There are no (further) constraints on this element
Element id
Slot.schedule.type
Short description
Type the reference refers to (e.g. "Patient")
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
+
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
+
Comments
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
There are no (further) constraints on this element
Element id
Slot.schedule.identifier
Short description
Logical reference, when literal reference is not known
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
+
Comments
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
+
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
+
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
+
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
There are no (further) constraints on this element
Element id
Slot.schedule.display
Short description
Text alternative for the resource
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
+
Comments
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
There are no (further) constraints on this element
Element id
Slot.start
Short description
Date/Time that the slot is to begin
Definition
Date/Time that the slot is to begin.
+
Comments
Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required
There are no (further) constraints on this element
Element id
Slot.end
Short description
Date/Time that the slot is to conclude
Definition
Date/Time that the slot is to conclude.
+
Comments
Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required
ele-1: All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
Mappings
rim: n/a
+
Folgende FHIRPath-Constraints sind im Profil zu beachten:
+
key
severity
human
expression
ISiK-slot-1
error
Der Endzeitpunkt eines Terminsblocks MUSS nach dem Startzeitpunkt liegen
start <= end
+
+
+
Anmerkungen zu Must-Support-Feldern
+
Slot.schedule
+
Bedeutung: Verknüpfung einer Termins / Terminblocks und den dazugehörigen Terminlisten bzw. deren Ressourcen.
+
Hinweise: Die Referenz auf Schedule bietet die Möglichkeit der Abfrage eines Appointments / Slots auf Basis einer Verknüpfung mit einem Schedule bzw. eines Schedules für eine bestimmte Ressource (Schedule.actor).
+
Slot.status
+
Bedeutung: Indikator ob ein Slot verwendbar ist für die Buchung eines Appointments.
+
Hinweise: Inbesondere eine Differenzierung des Status "busy" ermöglicht es einem Termin Requestor passende Termine einer BenutzerIn zur Verfügung zu stellen. Durch entsprechende Kombinationen können somit Termine in einer passenden Länge gebucht werden.
+
Slot.start
+
Bedeutung: Startdatum des Slots (sekundengenau).
+
Hinweise: Falls sich ein Appoinment über mehrere Slots erstreckt, kann mit Hilfe des Startdatums der Beginn eines zu vereinbarenden Termins gefunden werden.
+
Slot.end
+
Bedeutung: Enddatum des Slots (sekundengenau).
+
Hinweise: Falls sich ein Appoinment über mehrere Slots erstreckt, kann mit Hilfe des Enddatums der Slot gefunden werden, welcher als nächste innerhalb einer Reihe gebucht werden muss, sodass das Appointment eine gewünschte Länge erreicht.
+
+
Interaktionen
+
Für die Ressource Slot MUSS die REST-Interaktion "READ" implementiert werden.
Der Suchparameter "schedule" MUSS in Kombination mit einem definierten Startzeitpunkt mittels Suchparameter "start" unterstützt werden. Der Suchparameter "schedule" KANN alleinstehend unterstützt werden.
+Beim Fehlen des "start"-Suchparameters SOLL der aktuelle Zeitpunkt des Servers als Startzeitpunkt per Default verwendet werden.
+
Beispiele:
+
GET [base]/Slot?schedule=Schedule/ISiKKalenderExample&start=2022-12-10T09:00:00Z
+
GET [base]/Slot?schedule=Schedule/ISiKKalenderExample
+
Anwendungshinweise: Weitere Informationen zur Suche nach "Slot.schedule" finden sich in der [FHIR-Basisspezifikation - Abschnitt "reference"]https://hl7.org/fhir/R4/search.html#reference).
+
In diesem Fall ist auch ein Chaining auf weitere verknüpfte Akteure möglich: GET https://example.org/fhir/Slot?schedule.actor:HealthcareService.type=https://example.org/fhir/CodeSystem/Behandlungsleistung|CT
+
+
+
Dies kann notwendig sein, falls interdisziplinäre Kalender durch das Termin-Repository gepflegt werden (z.B. ein Kalender pro Station). In solchen Fälle wäre es sinnvoll, wenn das Termin-Repository einem Termin-Requestor eine Verknüpfung zwischen Kalender (Schedule) und Behandlungsleistung (HealthcareService) bereitstellen würde.
+
+
Der Suchparameter "status" MUSS in Kombination ('&') mit einer Abfrage auf Schedule unterstützt werden. Diese Abfrage KANN entweder eine direkte Angabe einer Referenz oder eine Angabe von weiteren Chaining-Parametern sein:
+
Beispiele:
+
GET [base]/Slot?status=free&schedule=Schedule/ISiKTerminExample
+
GET [base]/Slot?status=free&schedule.actor:Practitioner.name=Musterarzt
+
Anwendungshinweise: Der Suchparameter MUSS NICHT alleinstehend unterstützt werden. Weitere Informationen zur Suche nach "Slot.status" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
+
+
Der Suchparameter "start" MUSS in Kombination ('&') mit einer Parameter-Abfrage auf Schedule unterstützt werden. Diese Abfrage KANN entweder eine direkte Angabe einer Referenz oder eine Angabe von weiteren Chaining-Parametern sein:
+
Beispiele:
+
GET [base]/Slot?start=2022-12-10T09:00:00Z&schedule=Schedule/ISiKTerminExample
+
GET [base]/Slot?start=2022-12-10T09:00:00Z&schedule.actor:Practitioner.name=Musterarzt
+
Anwendungshinweise: Der Suchparameter MUSS NICHT alleinstehend unterstützt werden. Weitere Informationen zur Suche nach "Slot.start" finden sich in der FHIR-Basisspezifikation - Abschnitt "Date Search".
+
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+ Implementierungsleitfaden ISiK-Terminplanung
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Operations
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Es gelten die allgemeinen Vorgaben der FHIR-Kernspezifikation für die Ausführung von Custom Operations.
+
+
Buchung eines Termins
+
Invocations
URL: [base]/Appointment/$book
+
This operation changes content
Parameters (In)
Name
Cardinality
Type
Documentation
appt-resource
1..1
Appointment
Eine Appointment-Ressource entsprechend dem dazugehörigen ISiK-Profil MUSS übergeben werden. Falls das Parameter-Element 'Appointment' als einziges Parameter-Element verwendet wird, SOLL die Appointment-Ressource direkt im HTTP Body übergeben werden, alternativ zu einer Parameter-Ressource inklusive dem eingebetteten Appointment-Element. Invalide Ressourcen MÜSSEN abgelehnt werden durch das Termin Repository (zur Form der Ablehnung s.u.). Das Appointment MUSS den Status 'proposed' enthalten. Bei Terminverschiebungen (keine Terminabsage!) kann ein Appointment mit einem angepassten Zeitfenster in diesem Parameter übergeben werden. Appointment-Ressourcen, die dem Termin-Repository bekannt sind unter der im Appointment enthaltenen id, MÜSSEN durch das Termin-Repository geupdatet werden unter Beibehaltung der id.
cancelled-appt-id
0..1
uri
Im Falle einer Terminverschiebung kann die Situation vorkommen, dass Terminressourcen (z.B. Räume oder angebotene Dienstleistungen) nicht verfügbar sind. Dadurch kann es notwendig sein, den zu verschiebenden Termin neu zu planen. Dies wird als zweistufiger Prozess durch die $book-Operation unterstützt, bei dem ein Termin storniert und ein neuer Termin neu gebucht wird. Dieser Parameter repräsentiert die Ressourcen-Id des zu stornierenden Appointments. Der uri-Parameter kann eine absolute URL enthalten, Server SOLLEN jedoch nur Termine für ihre eigene Domäne verwalten. Im neu-angelegten Appointment MUSS eine Reference auf den abgesagten Termin hinterlegt werden (vgl. Appointment.extension:replaces) durch den Server. Der Status der abgesagten Ressource MUSS durch den Server angepasst werden (status = 'cancelled'). Die Verschiebung ist als transaktionale Operation zu verstehen, d.h. die Absage des originalen Termins DARF durch den Server nur bestätigt werden, wenn der neue vorgeschlagene Termin angenommen werden kann. Andernfalls MUSS die Terminverschiebung mit einem entsprechenden Hinweis abgelehnt werden.
Im Falle dass ein Appointment keine Referenz auf ein oder mehrere Slots enthält, MUSS der Server die benötigten Slots auf Basis der Referenz auf Schedule, sowie dem Start- und Endzeitpunkt im Appointment ermitteln.
Return Values (Out)
Name
Cardinality
Type
Documentation
return
0..1
Appointment
Falls die Interaktion erfolgreich ist, ist der Status Code HTTP 201 - Created zurückzugeben. Im Erfolgsfall MUSS als Return-Parameter eine Appointment-Ressource (entsprechend dem dazugehörigen ISiK-Profil) zurückgegeben werden. Das id-Element der Appointment-Ressource MUSS korrekt gefüllt werden. Der Server MUSS den Status der Appointment-Ressource auf 'booked' oder 'pending' ändern. Der Server MUSS die verwendeten Slot-Ressourcen als Referenz im Appointment angeben. Die Appointment-Ressource SOLL direkt im HTTP Body zurückgegeben werden, falls es sich um den einzigen Rückgabewert handelt. Alternativ kann die Appointment-Ressource innerhalb einer Parameter-Ressource zurückgegeben werden. Als Teil der Parameter-Ressource können zusätzlich Hinweise zum Termin als OperationOutcome zurückgegeben werden.
return
0..1
OperationOutcome
Falls die Interaktion fehlschlägt, MUSS als Return-Parameter eine OperationOutcome-Ressource zurückgegeben werden. Syntaktische Fehler in der Appointment-Ressource MUSS mit einem HTTP Status-Code 400 - Bad Request zurückgewiesen werden. Anderweitig invalide Appointment-Ressourcen MÜSSEN mit einer OperationOutcome-Ressource abgewiesen werden. In diesem Fall SOLL der HTTP Status-Code HTTP 422 - Unprocessable Entity verwendet werden. Eine OperationOutcome-Ressource KANN zu informativen Zwecken in jedem Fall zurückgegeben werden (s.o.).
+
Übersicht Interaktion Termin-Requestor mit Termin-Repository
+
Folgende Schritte KÖNNEN notwendig sein, sodass ein Termin durch einen Termin-Requestor innerhalb eines Termin-Repository eingestellt wird. Es ist zu beachten, dass für spezielle Implementierungen nicht alle Schritte hiervon relevant sind und übersprungen werden können.
+
Generell wird darauf hingewiesen, dass abhängig davon, welcher Client oder Benutzer eine Interaktion ausführt, unterschiedliche Ergebnisse zurückgeliefert werden können. Die vorliegende Spezifikation macht keine Vorgaben, wie eine Authentifizierung und Autorisierung zu implementieren ist. Es wird hierzu auf das ISiK-Modul 'Sicherheit' verwiesen.
+
User Story für die folgenden Beispiele: Ein Patient bucht über ein externes Patientenportal einen Termin in der allgemeinmedizinischen Ambulanz eines Krankenhauses. Da der Patient seit Tagen Bauchschmerzen hat, die in den letzten Stunden stärker werden, wählt er die Priorität "Notfall".
+
+
Abfrage aller Kodierungen der angebotenen gesundheitlichen Dienstleistungen durch den Termin-Requestor: GET https://example.org/fhir/CodeSystem?context-type-value=https://gematik.de/fhir/isik/CodeSystem/ContextType|ResourceUsage$http://hl7.org/fhir/resource-types|HealthcareService bzw. GET https://example.org/fhir/CodeSystem?context-type-value=https://gematik.de/fhir/isik/CodeSystem/ContextType|ResourceUsage$http://hl7.org/fhir/resource-types|Schedule
+
+
Das Termin-Repository MUSS alle CodeSysteme exponieren, welche für die Kodierung einer verfügbaren gesundheitlichen Dienstleistungen relevant sind. Die Anfrage ist nicht auf HealthcareService beschränkt, weitere Ressourcen-Kontexte können hierfür relevant sein. Beispielsweise erfolgt die Kodierung der Leistungen für einen Behandler im Kontext eines Schedules (vgl. Schedule.serviceType). Alle verwendeten CodeSysteme MÜSSEN exponiert werden, insoweit diese sich als CodeSystem-Ressourcen ausdrücken lassen.
+
Hinweis: Diese Abfrage ist für eine Initialisierung des Termin-Requestors gedacht. Es ist davon auszugehen, dass diese Auswahlliste nicht dynamisch angepasst wird durch das Termin-Repository und nicht bei jeder Terminbuchung erneut abgefragt werden muss.
+
+
Abfrage aller verfügbaren Kalender durch den Termin-Requestor: GET https://example.org/fhir/Schedule bzw. GET https://example.org/fhir/Schedule?actor=Practitioner/ISiKPractitionerExample
+
+
Der Termin-Requestor KANN durch die Abfrage aller verfügbaren Kalender aller Ressourcen abfragen, für die eine Terminbuchung zur Verfügung stehen. Diese Abfrage kann auf ein oder mehrere Akteure eingeschränkt werden.
+
+
Abfrage aller verfügbaren Slots für einen Kalender durch den Termin-Requestor: GET https://example.org/fhir/Slot?schedule=<Schedule/ISiKKalenderExample>&status=free
+
+
In diesem Fall ist auch ein Chaining auf weitere verknüpfte Akteure möglich: GET https://example.org/fhir/Slot?schedule.actor:HealthcareService.type=http://dicom.nema.org/resources/ontology/DCM|CT
+
+
Anlage einer Patient-Ressource durch den Termin-Requestor: POST https://example.org/fhir/Patient
Für den Fall, dass ein Termin-Repository zum aktuellen Zeitpunkt keine Terminbestätigung geben kann, wird in der Antwortnachricht zurückgegebenen Appointment-Ressource der Wert von "Appointment.status" auf "pending" gesetzt. Als HTTP-Status-Code MUSS das Termin-Repository "202 - Accepted" zurückgeben.
+Beispielsweise kann dies der Fall sein, falls ein Termin zunächst manuell im Termin-Repository bestätigt werden muss. Sobald ein Termin im Status "pending" seitens des Termin-Repository bestätigt oder abgesagt wurde, MUSS das Termin-Repository den Status des Termins auf "booked" bzw. "canceled" stellen. Sofern dieses unterstützt wird, SOLL eine Benachrichtigung des Termin-Consumers per Push-Mechanismus erfolgen (siehe auch nächster Abschnitt). In jedem Fall MUSS der Termin-Consumer über eine Lese- oder Such-Anfrage jederzeit den aktuellen Status der Terminbuchung ermitteln können.
+
+
Aktualisierung / Absage eines Termins
+
Es ist zu beachten, dass es aus Effizienzgründen für bestimmte Implementierungen sinnvoll sein kann, dass Updates einer Appointment-Ressource ausgelöst durch das Termin-Repository mittels eines Push-Mechanismus an Termin-Consumer / Termin-Requestor übermittelt werden. Im Standard-Fall müssen diese Akteure die Ressourcen mittels des entsprechenden Endpunktes eigenständig abfragen und auf Updates überprüfen. Für einen Push-Mechanismus wird auf FHIR Subscriptions verwiesen. Die vorliegende Spezifikation macht jedoch KEINE Vorgaben für die Verwendung einer solchen Methodik.
+
Eine Aktualisierung der Ressource erfolgt mittels einer HTTP PATCH-Interaktion. Updates einer Appointment-Ressource MUSS das Termin Repository unterstützen. Es MUSS mindestens die PATCH-Interaktion auf Basis einer FHIRPath-Patch-Parameter Ressource unterstützt werden.
+
Folgende Elemente DÜRFEN NICHT durch ein Update der Ressourcen verändert werden:
+
+
Appointment.slot
+
Appointment.start
+
Appointment.end
+
Appointment.participant.actor.where(resolve() is Patient)
+
+
Hinweis: Hinweis: Ein Termin Repository MUSS einen Termin ablehnen, falls der Termin auf einen nicht vorhandenen (gelöscht oder inkativ) Patienten referenziert. Dies gilt insbesondere auch nachträglich für vorläufig angelegte Patienten-Ressourcen.
+
Sollte die PATCH-Parameter-Ressource eins dieser Elemente verändern, MUSS die Operation mit einem Status Code "HTTP 400 - Bad Request" zurückgewiesen werden. Eine OperationOutcome Ressource MUSS zurückgegeben werden, die in kodierter Form den entsprechenden Fehler beschreibt.
Falls die Aktualisierung eines Termins die Veränderung eines der oben genannten Elemente zur Folge hat, z.B. aufgrund einer zeitlichen Verschiebung des Termins, so kann die Appointment-Ressource erneut unter Beibehaltung der id an die $book-Operation übergeben werden. Das Termin-Repository kann so feststellen, ob der Termin in abgeänderter Form verfügbar ist.
+
+
Anlage einer Patient-Ressource
+
Ein Termin Repository MUSS die Anlage (Create-Interaktion) einer Patient-Ressource entsprechend der Vorgaben des ISiK-Basismoduls unterstützen.
+
+
Asynchrone Ausführung $book
+
Die Operation zur Buchung eines Termin MUSS ebenfalls asynchron ausgeführt werden können, für den Fall, dass ein Termin-Repository keine Zusagen zu Antwortzeiten machen kann und so dass Problem besteht, dass der Client in einen Timeout läuft. Beispielsweise kann dies der Fall sein, wenn die Buchungsanfrage im Termin-Repository asynchrone Anfragen an andere Systeme auslöst und der Termin erst bestätigt werden kann, wenn diese durchgelaufen sind. Es gelten die Regeln der FHIR Kernspezifikation - Abschnitt 3.2.0.7 Executing an Operation Asynchronously:
+
+
Der Aufruf der $book-Operation erfolgte auch im asynchronen Fall durch einen POST-Request
+
Ein HTTP-Header mit dem Namen "Prefer" und dem Inhalt "respond-async" MUSS im Aufruf der Operation enthalten sein
+
Als HTTP-Status-Code MUSS das Termin-Repository 202 - Accepted zurückgeben
+
Im Fehlerfall MUSS ein 4XX- oder 5XX-HTTP-Status-Code zurückgeben werden
+
Zudem MUSS das Termin-Repository einen "Content-Location"-Header zurückliefern indem eine valide absolute URL enthalten ist unter welcher die oben beschriebene Appointment- bzw OperationOutcome-Ressource als Antwort auf die Buchung des Termins abgerufen werden kann
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+ Implementierungsleitfaden ISiK-Terminplanung
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Datenobjekte
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Folgende Datenobjekte aus dem Modul ISiK Basis Stufe 4 werden in diesem Modul verwendet:
Die Verwendung in diesem Modul bedeutet:
+Wenn dieses Modul auf Datenobjekte aus dem Basismodul referenziert, dann MÜSSEN die referenzierten FHIR-Ressourcen konform zu den Vorgaben aus dem Basismodul sein.
+Die Referenzierung von im Basismodul spezifizierten Datenobjekten, bedeutet nicht, dass die Interaktionen für die entsprechenden Datenobjekte aus dem Basismodul auch im Modul Terminplanung bestätigungsrelevant sind.
+
Darüber hinaus gelten in diesem Modul folgende Datenobjekt-spezifische Festlegungen:
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+ Implementierungsleitfaden ISiK-Terminplanung
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Version: 4.0.0-rc2
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Datum: 26.06.2024
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Status: Draft (Benehmen)
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Realm: Deutschland
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+
Interoperabler Datenaustausch durch Informationssysteme im Krankenhaus (ISiK)
+
Die gematik wurde vom Gesetzgeber beauftragt, im Benehmen mit der Deutschen Krankenhausgesellschaft (DKG) und den maßgeblichen Bundesverbänden der Industrie im Gesundheitswesen, verbindliche Standards für den Austausch von Gesundheitsdaten mit Informationssystemen im Krankenhaus zu erarbeiten. Dieser FHIR ImplementationGuide (IG) beschreibt die für diesen Zweck entwickelten FHIR Profile und das REST-basierte Application Programming Interface (API). Die REST-API wird im Wesentlichen vom FHIR Standard vorgegeben. Dieser Leitfaden konkretisiert die ISiK-relevanten Funktionen der Standard-REST-API und trifft inhaltliche Festlegungen zu den ISiK-relevanten Ressourcen in Form von Ressourcen-Profilen.
+
Hersteller bestätigungsrelevanter Systeme sollen durch diesen IG in die Lage versetzt werden, eine konforme Implementierung zu erstellen und das Bestätigungsverfahren der gematik erfolgreich zu absolvieren.
Hinweis: Sowohl für die Implementierung der ISiK-Spezifikation als auch für den Betrieb eines Produktes, das die ISiK-Spezifikation implementiert, ist eine SNOMED-CT-Lizenz notwendig. Diese kann beim National Release Center für SNOMED CT in Deutschland beantragt werden.
+
Kontakt
+
Bringen Sie allgemeine Fragen und Anmerkungen gerne über unser Anfrageportal ein: Anfragen ISiK + ISiP
+
Falls Sie keinen Zugang zum Anfrageportal haben und dieses nutzen wollen, senden Sie uns bitte eine Nachricht an die Adresse isik [ at ] gematik.de mit dem Betreff "Portalzugang".
Zugunsten des Leseflusses wird in dieser Publikation meist die
+männliche Form verwendet. Wir bitten, dies nicht als Zeichen einer
+geschlechtsspezifischen Wertung zu deuten. Diese Variante deckt auch alle
+weiteren Geschlechter, neben männlich und weiblich, ab.
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+ Implementierungsleitfaden ISiK-Terminplanung
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Motivation
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Die Vereinbarung von Terminen für Behandlungsleistungen repräsentiert oftmals für Patienten oder für sie zuständige Leistungserbringer den Einstieg in den Versorgungsablauf im Krankenhaus. Die Terminplanung agiert somit als kritische Schnittstelle zwischen diversen Akteuren im Gesundheitswesen, inklusive der zu behandelnden Personen. Informationen zu notwendigen und/oder gewünschten Behandlungen, Verfügbarkeiten der involvierten Personen und abrechnungsrelevante Details zur Krankenversicherung müssen potenziell ausgetauscht werden, um einen optimierten Ablauf des Aufenthaltes im Krankenhaus zu ermöglichen.
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Das Krankenhauszukunftsgesetz (KHZG) hebt die zentrale Rolle der Terminvereinbarung hervor in dem in den dazugehörigen Fördertatbeständen Vorgaben für die Terminplanung im digitalen Aufnahmemanagement bzw. für die Terminplanung mittels Patientenportalen gemacht werden (vgl. §19 Abs. 1 Satz 1 Nr. 2 KHSFV bzw. §21 Abs. 2 KHSFV).
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Angelehnt an diese Vorgaben soll mittels ISiK die Grundlage geschaffen werden, um die beschriebenen oder ähnliche Use Cases durchzuführen und die fachlich-inhaltlichen Informationen in einer interoperablen Art und Weise auszutauschen. ISiK versteht sich somit als Schnittstellenbeschreibung, um eine einheitliche API zu dokumentieren, durch die ein Termin vereinbart und verwaltet werden kann. Das vorliegende ISiK-Modul bietet somit explizit KEIN umfassendes Datenmodell für die krankenhausinterne Ressourcenplanung. Hingegen werden durch ISiK Minimalvorgaben für bestätigungsrelevante Systeme spezifiziert, auf die komplexere Workflows ausgestaltet werden können.
+
Durch ISiK Terminplanung sollen folgende Möglichkeiten eröffnet werden:
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+
Abruf von Abbildungen von verfügbaren teil- und voll- stationären Behandlungsleistungen durch ein Krankenhaus
+
Abfrage von Terminen und Verfügbarkeiten
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Buchungsmanagement von verfügbaren Terminen
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Benachrichtigungen bei Terminänderungen
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Anlage eines neuen Patienten im terminführenden System (Übermittlung Patient/Versicherungsinformationen)
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diff --git a/IG/4.0.0-rc2/ImplementationGuide-markdown-ReleaseNotes.html b/IG/4.0.0-rc2/ImplementationGuide-markdown-ReleaseNotes.html
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+ Implementierungsleitfaden ISiK-Terminplanung
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Release Notes
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Im Rahmen der ISiK-Veröffentlichungen wird das Semantic Versioning verwendet.
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Die erste Ziffer X bezeichnet ein Major-Release und regelt die Gültigkeit von Releases. Die dritte Ziffer Y (Release x.0.y) bezeichnet eine technische Korrektur und versioniert kleinere Änderungen (Packages) während eines Jahres, z. B. 1.0.1.
ISiKNachricht: Hinweis zum Thema Sicherheit eingefügt. Ohne weitere Maßnahmen können über ISiKNachricht keine medizinischen Daten ausgetauscht werden. Hierfür sollte daher bevorzugt die ePA verwendet werden.
Kardinalität der Elemente Appointment.specialty und Appointment.serviceType von 1..* auf 0..* geändert. MustSupport dieser Elemente von "true" auf "false" geändert.
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FHIR erlaubt die Anlage von Appointments ohne Bindung an einen Slot und außerhalb des Worksflows über einen Kalender. Dies kann z.B. auch dann erforderlich sein, wenn ein Termin außerhalb der definierten Slots per Telefon vereinbart und dann in das System eingespeist wird. In diesem Fall findet keine "Vererbung" von serviceType und specialty aus einem Kalender statt. Die Person, die den Termin in das System einträgt sollte hier selbst entscheiden können, welche Attribute sie explizit angibt und welche sich implizit aus dem Kontext erschließen.
+
ISiK Terminblöcke referenzieren auf Kalender, die auch andere als ISIK Kalender sein können. Damit ist nicht sichergestellt, dass eine durchgängige, automatische "Vererbung" von specialty und serviceType über Schedule und Slot in ein Appointment möglich ist (in FHIR Schedule und ISiK Terminblock ist die Kardinalität jeweils "0..*", d.h. diese Angaben können auch gänzlich fehlen).
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Kongruenz der Angaben in Appointment.start/end und Appointment.slot.start/end von MUSS auf SOLL herabgestuft.
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s.o. Bei off-band-Buchungen wird eine gewisse Flexibilität im Umgang mit dem Kalender benötigt.
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Hinweise zu den erwarteten Ergebnissen bei Suchanfragen auf "sepcialty" und "serviceType" in Fällen, bei denen diese Elemente keinen Wert haben.
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ISiKBookOperation : Für die Abbildung eines manuellen Buchungsprozesses wurden die Vorgaben zu den Return Values beim Appointment.status um "pending" erweitert
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Reference(Schedule) statt Reference(ISiKKalender). Reference-Element erweitert auf die Kernspezifikation (entspricht allgemeinem Design-Prinzip), damit die Profile auch außerhalb des ISiK-Kontextes nutzbar sind.
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+
+
Update Basismodul Dependency -> 2.0.4
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weitere Änderungen an IG (informativ)
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+
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Version: 2.0.1
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Datum: 31.10.2022
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Update Basismodul Dependency -> 2.0.2
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Version: 2.0.0
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Datum: 30.06.2022
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Initialer Release
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Version: 2.0.0 (Ballotierung)
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Datum: 31.03.2022
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Initiale Ballotierungsversion für ISiK Stufe 2
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Akteure
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Innerhalb des ISiK Moduls Terminplanung kann ein beteiligtes System verschiedene Rollen einnehmen und somit unterschiedliche Aufgaben innerhalb der im Abschnitt Interaktionen definierten Arbeitsabläufe übernehmen. Im Weiteren werden diese Rollen mithilfe der Definition von Akteuren formalisiert, sodass eine Zuordnung von relevanten Interaktionen zum jeweiligen Akteur erfolgen kann.
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Grundsätzlich wird als Terminblock eine für einen Termin buchbare Zeiteinheit verstanden, in der bestimmte Ressourcen (z.B. Fachabteilungen, Personen im Gesundheitswesen, Geräten, Räumen) zur Verfügung stehen. Übergreifend über ein oder mehrere Terminblöcke hinweg kann für diese Ressourcen anschließend ein Termin vereinbart werden.
+
Termin Repository
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Definition:
+
Als Termin Repository werden alle Systeme definiert, die Informationen zu verfügbaren Termineinheiten von Ressourcen (vgl. zuvor genannte Definition) vorhalten und die dafür vereinbarten Termine als führendes System verwalten.
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Das Termin Repository kann intern in ein Repository für die Termine und ein separates Repository für die buchbaren Terminblöcke (Terminblock Repository) geteilt werden.
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Beispielsysteme:
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Patientenportal im Falle, dass das System selbst terminführend ist
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KIS / KAS inkl. Terminverwaltung
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Termin Requestor / Termin Source
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Definition:
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Als Termin Requestor (in Anlehnung an die IHE Terminologie auch als Termin Source zu bezeichnen) werden alle Systeme definiert, die zur Erhebung, Erfassung, Anpassung oder Veränderung von Termininformationen dienen. Ein Termin Requestor verfügt über keine permanente Persistierung der verarbeiteten Informationen. Der Termin Requestor übernimmt die Koordination der Schnittstellenaufrufe, um einen Termin zu buchen.
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Beispielsysteme:
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Patientenportal im Falle, dass ein externes System das terminführende System ist
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Termin Consumer
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Definition:
+
Als Termin Consumer werden alle System definiert, die Termininformationen abfragen, um diese einer BenutzerIn zu präsentieren. Ein Termin Consumer verfügt über keine permanente Persistierung der abgefragten Informationen. Durch den Termin Consumer erfolgt explizit nur die Aufbereitung und Präsentation der Termininformationen. Eine anderweitige Verarbeitung der Termininformationen fällt in die Kategorie der anderen Akteure.
+
Beispielsysteme:
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Apps zum Anzeigen eines Kalenders
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Backendsysteme zum Versenden von Benachrichtigungen im Kontext eines Termins
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Ressourcenmanagementsoftware
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Übersicht der Akteure
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Es sei zu beachten, dass in vielen Fällen ein Terminmangementsystem aus unterschiedlichen Modulen besteht, die mehreren oder allen der genannten Akteure entsprechen:
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Ein Termin Repository, da das System das terminführende System ist
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Ein Termin Requestor, um intern im System einen Termin zu vereinbaren
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Ein Termin Consumer um eine Übersicht der vereinbarten Termine anzuzeigen
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+
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Darüber hinaus kann auch der Fall eintreten, dass ein Termin Repository als Termin Requestor interagiert. In diesem Fall ist das Termin Repository (z.B. ein Patientenportal) das terminführende System und übermittelt die vereinbarten Termine einem weiteren (internen) Termin Repository zur Synchronisation.
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Bestätigungsrelevante Systeme
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Die Festlegung der bestätigungsrelevanten Systeme ist im Implementierungsleitfaden des ISiK Basismodul Stufe 4 einsehbar.
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Interaktionen
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Für folgende Interaktionen werden im vorliegenden Implementierungsleitfaden Vorgaben für die Umsetzung innerhalb der ISiK-Schnittstelle definiert:
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Für die Auswahl eines verfügbaren Terminblocks kann es notwendig sein, dass das Termin Repository vorab durch den Termin Requestor Vorabinformationen (z.B. für die Krankenversicherung) erhält. Diese können über eine schreibende Schnittstelle an das Terminrepository übermittelt werden. Es ist zu beachten, dass das Termin Repository gegebenenfalls diese Informationen separat von eigens erstellten Datenobjekten vorhält und/oder die Information dauerhaft erst nach einer manuellen Überprüfung durch eine BenutzerIn freigibt.
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Gleichermaßen können Informationen zum Patienten vorab übermittelt werden, sodass gewisse Basisangaben bereits im Terminrepository vorliegen.
Als Einstiegspunkt in die Terminvereinbarung können durch den Termin Requester alle verfügbaren Behandlungsleistungen (HealthcareServices) abgerufen werden, für die das Termin Repository Informationen zu notwendigen Ressourcen (Räume, Personen, Geräte, etc.) bereitstellt.
Der Termin Requestor kann nach der Auswahl einer Behandlungsleistung verfügbare Terminlisten (Schedules) für diese im Termin Repository abrufen. Die Terminlisten repräsentieren somit den "Kalender" in dem Termine gebucht werden können.
Für einen jeweiligen Kalender kann der Termin Requestor die darin definierten Terminblöcke abfragen. Diese können entsprechend eines Zeitraums und/oder Status (verfügbar, belegt) gefiltert werden.
Für einen durch die BenutzerIn ausgewählten Terminblock bzw. mehreren aufeinander folgenden Terminblöcken kann durch den Termin Requestor ein Termin angefragt werden. Dieser kann direkt oder erst nach manueller Bestätigung durch das Termin Repository freigegeben werden.
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Es ist zu beachten, dass innerhalb dieser Aktion ein terminführendes Termin Repository die Rolle des Termin Requestors übernehmen kann und den neu-angelegten Termin in ein weiteres Terminrepository spiegelt.
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In diesem Kontext kann das Termin-Repsoitory zudem Zusatzinformationen (z.B. Lagepläne) an den Termin-Requestor übermitteln.
Termine können sowohl durch den Termin Requestor als Client oder durch das Termin Repository als terminführendes System verschoben werden. Im Falle, dass das Termin Repository den Termin verschiebt ist der Termin Consumer darüber zu benachrichtigen.
Termine können sowohl durch den Termin Requestor als Client oder durch das Termin Repository als terminführendes System durch Zusatzinformationen (z.B. welche Teilnehmer oder Ressourcen sind Teil des Termins) erweitert werden.
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In diesem Kontext kann der Termin-Requestor zudem Zusatzinformationen (z.B. Einwilligungen) an das Termin-Repository übermitteln.
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Kompatibilität zu anderen nationalen FHIR-basierten Spezifikationen
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Die vorliegende Spezifikation orientiert sich teilweise an bereits vorhandenen (internationalen) FHIR-Projekten zum Thema Terminvergabe. Hier sei vorallem das Argonaut Scheduling Project hervorgehoben.
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Kompatibilität zum KBV eTerminService
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Bei folgenden FHIR-Ressourcen existiert zum Zeitpunkt der Veröffentlichung eine inhatliche Überschneidung mit dem eTerminService der KBV:
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+
Patient - Jede ISiK "Patient"-Instanz ist auch valide gegen das entsprechende KBV ETS Profil falls:
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Elemente, die auf eine Kardinalität von 0..0 beschränkt sind, entfernt werden
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Appointment - Jede ISiK "Appointment"-Instanz ist auch valide gegen das entsprechende KBV ETS Profil falls:
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Elemente, die auf eine Kardinalität von 0..0 beschränkt sind, entfernt werden
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Eine PractitionerRole Referenz als Akteur angegeben wird
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Aufgrund von fachlichen Unterschieden in den zu unterstützenden Arbeitsabläufen sind die OperationDefinitions für die Buchung eines Termins nicht vergleichbar.
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Übergreifende Festlegungen
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Folgende Festlegungen aus dem Modul ISiK Basis Stufe 4 haben in diesem Modul Gültigkeit:
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Use Cases - Übersicht
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Im Folgenden wird ein grafischer Überblick über Anwendungsfälle (Use Cases) gegeben, die in diesem Modul relevant sind. Da es sich um eine Zusammenfassung handelt, werden nur folgende Use Case und dafür hinreichende Funktionen dargestellt:
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Allgemeine und intuitiv verständliche Use Cases.
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Kombinationen und weitere Details sind möglich.
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Übergreifende Use Cases und und ihre Sub Use Cases können in einem separaten Diagramm auf den entsprechenden Seiten gefunden werden.
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Allgemeine und intuitiv Adverse Use Cases (diese gilt es zu vermeiden)
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In den Funktionen werden triviale Suchen einer Ressource anhand ihrer eigenen Properties nicht dargestellt, z.B. Suche einer Ressource anhand der ID, Name, Code usw.
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Use Case Diagramm
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+ Implementierungsleitfaden ISiK-Terminplanung
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