{
"description": "Enables a practitioner, facility, or organization to attest to a treatment relationship with a patient. This profile documents that a healthcare provider has an active treatment relationship with the patient for the purposes of care delivery, coordination, and related activities. This profile is used in the Provider-Member-Match operation to enable providers to assert treatment relationships with patients for bulk data access.",
"_filename": "StructureDefinition-provider-treatment-relationship-consent.json",
"package_name": "hl7.fhir.us.davinci-pdex",
"date": "2024-12-16T00:00:00Z",
"derivation": "constraint",
"publisher": "HL7 International / Financial Management",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "US",
"system": "urn:iso:std:iso:3166",
"display": "United States of America"
} ]
} ],
"name": "ProviderTreatmentAttestation",
"mapping": [ {
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Pattern",
"identity": "workflow"
}, {
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping",
"identity": "v2"
}, {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
}, {
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern Mapping",
"identity": "w5"
} ],
"abstract": false,
"copyright": "Used by permission of HL7 International, all rights reserved Creative Commons License",
"type": "Consent",
"experimental": "false",
"resourceType": "StructureDefinition",
"title": "Provider Attestation to Treatment Relationship",
"package_version": "2.2.0",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fm"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 2,
"_valueInteger": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical": "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
} ]
}
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "trial-use",
"_valueCode": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical": "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
} ]
}
} ],
"snapshot": {
"element": [ {
"constraint": [ {
"key": "dom-2",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.contained.empty()"
}, {
"key": "dom-3",
"human": "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",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "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()"
}, {
"key": "dom-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-5",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.security.empty()"
}, {
"key": "dom-6",
"human": "A resource should have narrative for robust management",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "warning",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
} ],
"expression": "text.`div`.exists()"
}, {
"key": "ppc-1",
"human": "Either a Policy or PolicyRule",
"xpath": "exists(f:policy) or exists(f:policyRule)",
"source": "http://hl7.org/fhir/StructureDefinition/Consent",
"severity": "error",
"expression": "policy.exists() or policyRule.exists()"
}, {
"key": "ppc-2",
"human": "IF Scope=privacy, there must be a patient",
"xpath": "exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='patient-privacy'])))",
"source": "http://hl7.org/fhir/StructureDefinition/Consent",
"severity": "error",
"expression": "patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()"
}, {
"key": "ppc-3",
"human": "IF Scope=research, there must be a patient",
"xpath": "exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='research'])))",
"source": "http://hl7.org/fhir/StructureDefinition/Consent",
"severity": "error",
"expression": "patient.exists() or scope.coding.where(system='something' and code='research').exists().not()"
}, {
"key": "ppc-4",
"human": "IF Scope=adr, there must be a patient",
"xpath": "exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='adr'])))",
"source": "http://hl7.org/fhir/StructureDefinition/Consent",
"severity": "error",
"expression": "patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()"
}, {
"key": "ppc-5",
"human": "IF Scope=treatment, there must be a patient",
"xpath": "exists(f:patient) or not(exists(f:scope/f:coding[f:system/@value='something' and f:code/@value='treatment'])))",
"source": "http://hl7.org/fhir/StructureDefinition/Consent",
"severity": "error",
"expression": "patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()"
} ],
"path": "Consent",
"min": 0,
"definition": "A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.",
"isModifier": false,
"short": "A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "Event",
"identity": "workflow"
}, {
"map": "CON",
"identity": "v2"
}, {
"map": "FinancialConsent",
"identity": "rim"
} ],
"max": "*",
"id": "Consent",
"comment": "Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.",
"base": {
"max": "*",
"min": 0,
"path": "Consent"
},
"isSummary": false
}, {
"path": "Consent.id",
"min": 0,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"isModifier": false,
"short": "Logical id of this artifact",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
} ]
} ],
"max": "1",
"id": "Consent.id",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.meta",
"min": 0,
"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.",
"isModifier": false,
"short": "Metadata about the resource",
"type": [ {
"code": "Meta"
} ],
"max": "1",
"id": "Consent.meta",
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.implicitRules",
"min": 0,
"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.",
"isModifier": true,
"short": "A set of rules under which this content was created",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "Consent.implicitRules",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"isModifier": false,
"short": "Language of the resource content",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
} ],
"description": "A human language."
},
"max": "1",
"id": "Consent.language",
"comment": "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).",
"base": {
"max": "1",
"min": 0,
"path": "Resource.language"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.text",
"min": 0,
"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.",
"isModifier": false,
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "Consent.text",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
},
"isSummary": false
}, {
"path": "Consent.contained",
"min": 0,
"definition": "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.",
"isModifier": false,
"short": "Contained, inline Resources",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Resource"
} ],
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "*",
"id": "Consent.contained",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.identifier",
"min": 0,
"definition": "Unique identifier for this copy of the Consent Statement.",
"isModifier": false,
"short": "Identifier for this record (external references)",
"mapping": [ {
"map": "Event.identifier",
"identity": "workflow"
}, {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": ".id",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "*",
"id": "Consent.identifier",
"comment": "This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.",
"example": [ {
"label": "General",
"valueIdentifier": {
"value": "Local eCMS identifier",
"system": "http://acme.org/identifier/local/eCMS"
}
} ],
"base": {
"max": "*",
"min": 0,
"path": "Consent.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.status",
"requirements": "The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.",
"min": 1,
"definition": "Indicates whether this treatment relationship attestation is active, inactive, or has been entered in error",
"isModifier": true,
"short": "Status of the treatment relationship attestation",
"mapping": [ {
"map": "Event.status",
"identity": "workflow"
}, {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": "HL7 Table 0498 - Consent Status",
"identity": "v2"
}, {
"map": ".statusCode",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/attestation-status-valueset"
},
"max": "1",
"id": "Consent.status",
"comment": "This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.",
"base": {
"max": "1",
"min": 1,
"path": "Consent.status"
},
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.scope",
"min": 1,
"definition": "Fixed to 'patient-privacy' (Agreement to collect, access, use or disclose information). The Consent here is the provider's attestation that supports access to the patient's data via the Provider Access API; it is not a 'treatment' consent (which would be a patient's agreement to undergo a specific medical treatment).",
"isModifier": true,
"short": "Patient privacy / information disclosure scope",
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/consent-scope|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ConsentScope"
} ],
"description": "The four anticipated uses for the Consent Resource."
},
"max": "1",
"id": "Consent.scope",
"patternCodeableConcept": {
"coding": [ {
"code": "patient-privacy",
"system": "http://terminology.hl7.org/CodeSystem/consentscope"
} ]
},
"base": {
"max": "1",
"min": 1,
"path": "Consent.scope"
},
"isModifierReason": "Allows changes to codes based on scope selection",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.category",
"min": 1,
"definition": "Classification of the type of consent. Should include codes indicating treatment relationship and attestation",
"isModifier": false,
"short": "Classification of consent (e.g., treatment relationship, attestation)",
"mapping": [ {
"map": "Event.code",
"identity": "workflow"
}, {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": "HL7 Table 0497 - Consent Type",
"identity": "v2"
}, {
"map": "CNTRCT",
"identity": "rim"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/consent-category"
},
"max": "*",
"id": "Consent.category",
"base": {
"max": "*",
"min": 1,
"path": "Consent.category"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.patient",
"min": 1,
"definition": "Reference to the patient for whom the treatment relationship is being attested",
"isModifier": false,
"short": "Patient who is the subject of the treatment relationship",
"mapping": [ {
"map": "Event.subject",
"identity": "workflow"
}, {
"map": "FiveWs.subject[x]",
"identity": "w5"
}, {
"map": "Role",
"identity": "rim"
}, {
"map": "FiveWs.subject",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1" ]
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.patient",
"comment": "Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.",
"base": {
"max": "1",
"min": 0,
"path": "Consent.patient"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.dateTime",
"min": 1,
"definition": "When this treatment relationship attestation was recorded or last updated",
"isModifier": false,
"short": "Date/time when treatment relationship attestation was recorded",
"mapping": [ {
"map": "Event.occurrence[x]",
"identity": "workflow"
}, {
"map": "FiveWs.recorded",
"identity": "w5"
}, {
"map": "Field 13/ Consent Decision Date",
"identity": "v2"
}, {
"map": "FinancialConsent effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.dateTime",
"comment": "This is not the time of the original consent, but the time that this statement was made or derived.",
"base": {
"max": "1",
"min": 0,
"path": "Consent.dateTime"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.performer",
"min": 1,
"definition": "The healthcare provider (practitioner, organization, or facility) attesting that they have a treatment relationship with the patient. The performer element SHOULD be populated using performer.identifier with the provider's NPI (National Provider Identifier) so that the attesting provider can be identified without requiring a FHIR resource reference on the receiving system.",
"isModifier": false,
"short": "Practitioner, facility, or organization attesting to treatment relationship",
"mapping": [ {
"map": "Event.performer",
"identity": "workflow"
}, {
"map": "FiveWs.actor",
"identity": "w5"
}, {
"map": "Field 24/ ConsenterID",
"identity": "v2"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ]
} ],
"mustSupport": true,
"alias": [ "consentor" ],
"max": "*",
"id": "Consent.performer",
"comment": "Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.",
"base": {
"max": "*",
"min": 0,
"path": "Consent.performer"
},
"isSummary": true
}, {
"path": "Consent.performer.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Consent.performer.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.performer.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.performer.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.performer.reference",
"min": 0,
"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.",
"isModifier": false,
"short": "Literal reference, Relative, internal or absolute URL",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"max": "1",
"id": "Consent.performer.reference",
"condition": [ "ref-1" ],
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.reference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.performer.type",
"min": 0,
"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.\n\nThe 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).",
"isModifier": false,
"short": "Type the reference refers to (e.g. \"Patient\")",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "uri"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/resource-types|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "FHIRResourceTypeExt"
} ],
"description": "Aa resource (or, for logical models, the URI of the logical model)."
},
"max": "1",
"id": "Consent.performer.type",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.performer.identifier",
"min": 0,
"definition": "The National Provider Identifier (NPI) or other business identifier of the practitioner, facility, or organization attesting to the treatment relationship. Using an identifier allows the provider to be identified without requiring a resolvable FHIR resource reference.",
"isModifier": false,
"short": "NPI or other identifier of the performing provider",
"mapping": [ {
"map": ".identifier",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.performer.identifier",
"comment": "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. \n\nWhen 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\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.\n\nReference 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).",
"base": {
"max": "1",
"min": 0,
"path": "Reference.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.performer.display",
"min": 0,
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"isModifier": false,
"short": "Display name of the performing provider",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "string"
} ],
"mustSupport": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
} ],
"max": "1",
"id": "Consent.performer.display",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Reference.display"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.organization",
"min": 0,
"definition": "The healthcare organization under which this treatment relationship exists. Because the requester (provider/client) and the source/payer system maintain independent FHIR resource IDs, a literal `Reference.reference` value (e.g., `Organization/123`) is meaningful only inside the requester's system. To allow the source/payer to match the organization against its own records, the reference SHOULD be expressed as a *logical (identifier-based) reference* by populating `Reference.identifier` with a business identifier — typically the organization's NPI (`http://hl7.org/fhir/sid/us-npi`) — together with `Reference.display` for human readability. Alternatively, a `Reference.reference` MAY point to a `contained` Organization resource that itself carries the business identifier.",
"isModifier": false,
"short": "Organization responsible for the treatment relationship",
"mapping": [ {
"map": "Event.performer",
"identity": "workflow"
}, {
"map": "FiveWs.witness",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization|4.0.1" ]
} ],
"mustSupport": true,
"alias": [ "custodian" ],
"max": "1",
"id": "Consent.organization",
"base": {
"max": "*",
"min": 0,
"path": "Consent.organization"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.source[x]",
"min": 0,
"definition": "Reference to the source document, system, or person who provided the attestation",
"isModifier": false,
"short": "Source of the attestation",
"mapping": [ {
"map": "Field 19 Informational Material Supplied Indicator",
"identity": "v2"
} ],
"type": [ {
"code": "Attachment"
}, {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Consent|4.0.1", "http://hl7.org/fhir/StructureDefinition/DocumentReference|4.0.1", "http://hl7.org/fhir/StructureDefinition/Contract|4.0.1", "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse|4.0.1" ]
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.source[x]",
"comment": "The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.",
"base": {
"max": "1",
"min": 0,
"path": "Consent.source[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.policy",
"min": 0,
"definition": "References to applicable policies, regulations, or legal frameworks governing treatment relationships",
"isModifier": false,
"short": "Policies or regulations governing the treatment relationship",
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"max": "*",
"id": "Consent.policy",
"base": {
"max": "*",
"min": 0,
"path": "Consent.policy"
},
"isSummary": false
}, {
"path": "Consent.policy.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Consent.policy.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.policy.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.policy.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.policy.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "Consent.policy.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.policy.authority",
"min": 0,
"definition": "Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives.",
"isModifier": false,
"short": "Enforcement source for policy",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "Consent.policy.authority",
"condition": [ "ppc-1" ],
"base": {
"max": "1",
"min": 0,
"path": "Consent.policy.authority"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.policy.uri",
"min": 0,
"definition": "The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.",
"isModifier": false,
"short": "Specific policy covered by this consent",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "Consent.policy.uri",
"condition": [ "ppc-1" ],
"comment": "This element is for discoverability / documentation and does not modify or qualify the policy rules.",
"base": {
"max": "1",
"min": 0,
"path": "Consent.policy.uri"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.policyRule",
"requirements": "Might be a unique identifier of a policy set in XACML, or other rules engine.",
"min": 0,
"definition": "A reference to the specific base computable regulation or policy.",
"isModifier": false,
"short": "Regulation that this consents to",
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/consent-policy|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ConsentPolicyRule"
} ],
"description": "Regulatory policy examples."
},
"max": "1",
"id": "Consent.policyRule",
"condition": [ "ppc-1" ],
"comment": "If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource.",
"base": {
"max": "1",
"min": 0,
"path": "Consent.policyRule"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.verification",
"min": 0,
"definition": "Information about verification of the treatment relationship attestation",
"isModifier": false,
"short": "Verification of the treatment relationship attestation",
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"max": "*",
"id": "Consent.verification",
"base": {
"max": "*",
"min": 0,
"path": "Consent.verification"
},
"isSummary": true
}, {
"path": "Consent.verification.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Consent.verification.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.verification.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.verification.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.verification.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "Consent.verification.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.verification.verified",
"min": 1,
"definition": "Has the instruction been verified.",
"isModifier": false,
"short": "Whether the attestation has been verified",
"type": [ {
"code": "boolean"
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.verification.verified",
"base": {
"max": "1",
"min": 1,
"path": "Consent.verification.verified"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.verification.verifiedWith",
"min": 0,
"definition": "Who verified the instruction (Patient, Relative or other Authorized Person).",
"isModifier": false,
"short": "Who verified the attestation",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient|4.0.1", "http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1" ]
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.verification.verifiedWith",
"base": {
"max": "1",
"min": 0,
"path": "Consent.verification.verifiedWith"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.verification.verificationDate",
"min": 0,
"definition": "Date verification was collected.",
"isModifier": false,
"short": "When the attestation was verified",
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.verification.verificationDate",
"base": {
"max": "1",
"min": 0,
"path": "Consent.verification.verificationDate"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision",
"min": 0,
"definition": "Detailed provisions about the scope, purpose, and period of the treatment relationship",
"isModifier": false,
"short": "Details of the treatment relationship",
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.provision",
"base": {
"max": "1",
"min": 0,
"path": "Consent.provision"
},
"isSummary": true
}, {
"path": "Consent.provision.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Consent.provision.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.provision.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.provision.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.provision.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "Consent.provision.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.type",
"min": 0,
"definition": "For treatment relationships, this should typically be 'permit' indicating an active relationship",
"isModifier": false,
"short": "Whether this is a permission (permit) or denial",
"type": [ {
"code": "code"
} ],
"mustSupport": true,
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/attestation-provision-type-valueset"
},
"max": "1",
"id": "Consent.provision.type",
"base": {
"max": "1",
"min": 0,
"path": "Consent.provision.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.period",
"min": 0,
"definition": "The time period during which the treatment relationship is valid or was active",
"isModifier": false,
"short": "Time period for the treatment relationship",
"type": [ {
"code": "Period"
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.provision.period",
"base": {
"max": "1",
"min": 0,
"path": "Consent.provision.period"
},
"isSummary": true
}, {
"path": "Consent.provision.period.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Consent.provision.period.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.provision.period.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.provision.period.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.period.start",
"min": 0,
"definition": "The start of the period. The boundary is inclusive.",
"isModifier": false,
"short": "Start date of treatment relationship",
"mapping": [ {
"map": "DR.1",
"identity": "v2"
}, {
"map": "./low",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.provision.period.start",
"condition": [ "per-1" ],
"comment": "If the low element is missing, the meaning is that the low boundary is not known.",
"base": {
"max": "1",
"min": 0,
"path": "Period.start"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.period.end",
"min": 0,
"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.",
"isModifier": false,
"short": "End time with inclusive boundary, if not ongoing",
"mapping": [ {
"map": "DR.2",
"identity": "v2"
}, {
"map": "./high",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"meaningWhenMissing": "If the end of the period is missing, it means that the period is ongoing",
"max": "1",
"id": "Consent.provision.period.end",
"condition": [ "per-1" ],
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "Period.end"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.actor",
"min": 0,
"definition": "Specific practitioners, organizations, or facilities involved in providing care under this treatment relationship",
"isModifier": false,
"short": "Actors involved in the treatment relationship",
"type": [ {
"code": "BackboneElement"
} ],
"mustSupport": true,
"meaningWhenMissing": "There is no specific actor associated with the exception",
"max": "*",
"id": "Consent.provision.actor",
"base": {
"max": "*",
"min": 0,
"path": "Consent.provision.actor"
},
"isSummary": false
}, {
"path": "Consent.provision.actor.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Consent.provision.actor.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.provision.actor.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.provision.actor.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.provision.actor.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "Consent.provision.actor.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.actor.role",
"min": 1,
"definition": "How the individual is involved in the resources content that is described in the exception.",
"isModifier": false,
"short": "How the actor is involved",
"type": [ {
"code": "CodeableConcept"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/security-role-type|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ConsentActorRole"
} ],
"description": "How an actor is involved in the consent considerations."
},
"max": "1",
"id": "Consent.provision.actor.role",
"base": {
"max": "1",
"min": 1,
"path": "Consent.provision.actor.role"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.actor.reference",
"min": 1,
"definition": "Reference to the practitioner, organization, role, or care team involved in the treatment relationship. As with `Consent.organization`, a literal `Reference.reference` is meaningful only inside the requester's system. The reference SHOULD be expressed as a *logical (identifier-based) reference* by populating `Reference.identifier` with the actor's business identifier — typically the NPI (`http://hl7.org/fhir/sid/us-npi`) for Practitioner, PractitionerRole, or Organization actors — together with `Reference.display` for human readability, so that the source/payer system can match the actor against its own records without resolving a FHIR resource reference relative to the requester's system. Alternatively, the reference MAY point to a `contained` resource that itself carries the business identifier.",
"isModifier": false,
"short": "Identifier-based reference to the actor",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/CareTeam" ]
} ],
"mustSupport": true,
"max": "1",
"id": "Consent.provision.actor.reference",
"base": {
"max": "1",
"min": 1,
"path": "Consent.provision.actor.reference"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.action",
"min": 0,
"definition": "Actions controlled by this Rule.",
"isModifier": false,
"short": "Actions controlled by this rule",
"type": [ {
"code": "CodeableConcept"
} ],
"meaningWhenMissing": "all actions",
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/consent-action|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ConsentAction"
} ],
"description": "Detailed codes for the consent action."
},
"max": "*",
"id": "Consent.provision.action",
"comment": "Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.",
"base": {
"max": "*",
"min": 0,
"path": "Consent.provision.action"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.securityLabel",
"min": 0,
"definition": "A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.",
"isModifier": false,
"short": "Security Labels that define affected resources",
"type": [ {
"code": "Coding"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/security-labels|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SecurityLabels"
} ],
"description": "Security Labels from the Healthcare Privacy and Security Classification System."
},
"max": "*",
"id": "Consent.provision.securityLabel",
"comment": "If the consent specifies a security label of \"R\" then it applies to all resources that are labeled \"R\" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.",
"base": {
"max": "*",
"min": 0,
"path": "Consent.provision.securityLabel"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.purpose",
"min": 0,
"definition": "The purpose(s) for which the treatment relationship allows access to patient information (e.g., treatment, care coordination, quality improvement)",
"isModifier": false,
"short": "Purpose of accessing patient information",
"type": [ {
"code": "Coding"
} ],
"mustSupport": true,
"binding": {
"strength": "extensible",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0"
},
"max": "*",
"id": "Consent.provision.purpose",
"comment": "When the purpose of use tag is on the data, access request purpose of use shall not conflict.",
"base": {
"max": "*",
"min": 0,
"path": "Consent.provision.purpose"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.class",
"min": 0,
"definition": "The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.",
"isModifier": false,
"short": "e.g. Resource Type, Profile, CDA, etc.",
"type": [ {
"code": "Coding"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/consent-content-class|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ConsentContentClass"
} ],
"description": "The class (type) of information a consent rule covers."
},
"max": "*",
"id": "Consent.provision.class",
"comment": "Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.",
"base": {
"max": "*",
"min": 0,
"path": "Consent.provision.class"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.code",
"min": 0,
"definition": "If this code is found in an instance, then the rule applies.",
"isModifier": false,
"short": "e.g. LOINC or SNOMED CT code, etc. in the content",
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "example",
"valueSet": "http://hl7.org/fhir/ValueSet/consent-content-code|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ConsentContentCode"
} ],
"description": "If this code is found in an instance, then the exception applies."
},
"max": "*",
"id": "Consent.provision.code",
"comment": "Typical use of this is a Document code with class = CDA.",
"base": {
"max": "*",
"min": 0,
"path": "Consent.provision.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.dataPeriod",
"min": 0,
"definition": "Clinical or Operational Relevant period of time that bounds the data controlled by this rule.",
"isModifier": false,
"short": "Timeframe for data controlled by this rule",
"type": [ {
"code": "Period"
} ],
"max": "1",
"id": "Consent.provision.dataPeriod",
"comment": "This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.",
"base": {
"max": "1",
"min": 0,
"path": "Consent.provision.dataPeriod"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.data",
"min": 0,
"definition": "The resources controlled by this rule if specific resources are referenced.",
"isModifier": false,
"short": "Data controlled by this rule",
"mapping": [ {
"map": "Role",
"identity": "rim"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"meaningWhenMissing": "all data",
"max": "*",
"id": "Consent.provision.data",
"base": {
"max": "*",
"min": 0,
"path": "Consent.provision.data"
},
"isSummary": true
}, {
"path": "Consent.provision.data.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Consent.provision.data.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.provision.data.extension",
"min": 0,
"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.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Consent.provision.data.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Consent.provision.data.modifierExtension",
"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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "Consent.provision.data.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.data.meaning",
"min": 1,
"definition": "How the resource reference is interpreted when testing consent restrictions.",
"isModifier": false,
"short": "instance | related | dependents | authoredby",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ConsentDataMeaning"
} ],
"description": "How a resource reference is interpreted when testing consent restrictions."
},
"max": "1",
"id": "Consent.provision.data.meaning",
"base": {
"max": "1",
"min": 1,
"path": "Consent.provision.data.meaning"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.data.reference",
"min": 1,
"definition": "A reference to a specific resource that defines which resources are covered by this consent.",
"isModifier": false,
"short": "The actual data reference",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource|4.0.1" ]
} ],
"max": "1",
"id": "Consent.provision.data.reference",
"base": {
"max": "1",
"min": 1,
"path": "Consent.provision.data.reference"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Consent.provision.provision",
"min": 0,
"definition": "Rules which provide exceptions to the base rule or subrules.",
"isModifier": false,
"short": "Nested Exception Rules",
"contentReference": "http://hl7.org/fhir/StructureDefinition/Consent#Consent.provision",
"max": "*",
"id": "Consent.provision.provision",
"base": {
"max": "*",
"min": 0,
"path": "Consent.provision.provision"
},
"isSummary": false
} ],
"extension": [ {
"url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
"valueString": "4.0.1"
} ]
},
"status": "active",
"id": "94ba8e13-4829-46c9-b89d-c650756262cf",
"kind": "resource",
"url": "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-treatment-relationship-consent",
"identifier": [ {
"value": "urn:oid:2.16.840.1.113883.4.642.40.8.42.51",
"system": "urn:ietf:rfc:3986"
} ],
"version": "2.2.0",
"differential": {
"element": [ {
"id": "Consent.status",
"path": "Consent.status",
"short": "Status of the treatment relationship attestation",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/attestation-status-valueset"
},
"definition": "Indicates whether this treatment relationship attestation is active, inactive, or has been entered in error",
"mustSupport": true
}, {
"id": "Consent.scope",
"path": "Consent.scope",
"short": "Patient privacy / information disclosure scope",
"definition": "Fixed to 'patient-privacy' (Agreement to collect, access, use or disclose information). The Consent here is the provider's attestation that supports access to the patient's data via the Provider Access API; it is not a 'treatment' consent (which would be a patient's agreement to undergo a specific medical treatment).",
"mustSupport": true,
"patternCodeableConcept": {
"coding": [ {
"code": "patient-privacy",
"system": "http://terminology.hl7.org/CodeSystem/consentscope"
} ]
}
}, {
"id": "Consent.category",
"path": "Consent.category",
"short": "Classification of consent (e.g., treatment relationship, attestation)",
"binding": {
"strength": "extensible",
"valueSet": "http://hl7.org/fhir/ValueSet/consent-category"
},
"definition": "Classification of the type of consent. Should include codes indicating treatment relationship and attestation",
"mustSupport": true
}, {
"id": "Consent.patient",
"min": 1,
"path": "Consent.patient",
"short": "Patient who is the subject of the treatment relationship",
"definition": "Reference to the patient for whom the treatment relationship is being attested",
"mustSupport": true
}, {
"id": "Consent.dateTime",
"min": 1,
"path": "Consent.dateTime",
"short": "Date/time when treatment relationship attestation was recorded",
"definition": "When this treatment relationship attestation was recorded or last updated",
"mustSupport": true
}, {
"id": "Consent.performer",
"min": 1,
"path": "Consent.performer",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ]
} ],
"short": "Practitioner, facility, or organization attesting to treatment relationship",
"definition": "The healthcare provider (practitioner, organization, or facility) attesting that they have a treatment relationship with the patient. The performer element SHOULD be populated using performer.identifier with the provider's NPI (National Provider Identifier) so that the attesting provider can be identified without requiring a FHIR resource reference on the receiving system.",
"mustSupport": true
}, {
"id": "Consent.performer.identifier",
"path": "Consent.performer.identifier",
"short": "NPI or other identifier of the performing provider",
"definition": "The National Provider Identifier (NPI) or other business identifier of the practitioner, facility, or organization attesting to the treatment relationship. Using an identifier allows the provider to be identified without requiring a resolvable FHIR resource reference.",
"mustSupport": true
}, {
"id": "Consent.performer.display",
"path": "Consent.performer.display",
"short": "Display name of the performing provider",
"mustSupport": true
}, {
"id": "Consent.organization",
"max": "1",
"path": "Consent.organization",
"short": "Organization responsible for the treatment relationship",
"definition": "The healthcare organization under which this treatment relationship exists. Because the requester (provider/client) and the source/payer system maintain independent FHIR resource IDs, a literal `Reference.reference` value (e.g., `Organization/123`) is meaningful only inside the requester's system. To allow the source/payer to match the organization against its own records, the reference SHOULD be expressed as a *logical (identifier-based) reference* by populating `Reference.identifier` with a business identifier — typically the organization's NPI (`http://hl7.org/fhir/sid/us-npi`) — together with `Reference.display` for human readability. Alternatively, a `Reference.reference` MAY point to a `contained` Organization resource that itself carries the business identifier.",
"mustSupport": true
}, {
"id": "Consent.source[x]",
"path": "Consent.source[x]",
"short": "Source of the attestation",
"definition": "Reference to the source document, system, or person who provided the attestation",
"mustSupport": true
}, {
"id": "Consent.policy",
"path": "Consent.policy",
"short": "Policies or regulations governing the treatment relationship",
"definition": "References to applicable policies, regulations, or legal frameworks governing treatment relationships",
"mustSupport": true
}, {
"id": "Consent.verification",
"path": "Consent.verification",
"short": "Verification of the treatment relationship attestation",
"definition": "Information about verification of the treatment relationship attestation",
"mustSupport": true
}, {
"id": "Consent.verification.verified",
"path": "Consent.verification.verified",
"short": "Whether the attestation has been verified",
"mustSupport": true
}, {
"id": "Consent.verification.verifiedWith",
"path": "Consent.verification.verifiedWith",
"short": "Who verified the attestation",
"mustSupport": true
}, {
"id": "Consent.verification.verificationDate",
"path": "Consent.verification.verificationDate",
"short": "When the attestation was verified",
"mustSupport": true
}, {
"id": "Consent.provision",
"path": "Consent.provision",
"short": "Details of the treatment relationship",
"definition": "Detailed provisions about the scope, purpose, and period of the treatment relationship",
"mustSupport": true
}, {
"id": "Consent.provision.type",
"path": "Consent.provision.type",
"short": "Whether this is a permission (permit) or denial",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/us/davinci-pdex/ValueSet/attestation-provision-type-valueset"
},
"definition": "For treatment relationships, this should typically be 'permit' indicating an active relationship",
"mustSupport": true
}, {
"id": "Consent.provision.period",
"path": "Consent.provision.period",
"short": "Time period for the treatment relationship",
"definition": "The time period during which the treatment relationship is valid or was active",
"mustSupport": true
}, {
"id": "Consent.provision.period.start",
"path": "Consent.provision.period.start",
"short": "Start date of treatment relationship",
"mustSupport": true
}, {
"id": "Consent.provision.actor",
"path": "Consent.provision.actor",
"short": "Actors involved in the treatment relationship",
"definition": "Specific practitioners, organizations, or facilities involved in providing care under this treatment relationship",
"mustSupport": true
}, {
"id": "Consent.provision.actor.role",
"path": "Consent.provision.actor.role",
"mustSupport": true
}, {
"id": "Consent.provision.actor.reference",
"path": "Consent.provision.actor.reference",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/CareTeam" ]
} ],
"short": "Identifier-based reference to the actor",
"definition": "Reference to the practitioner, organization, role, or care team involved in the treatment relationship. As with `Consent.organization`, a literal `Reference.reference` is meaningful only inside the requester's system. The reference SHOULD be expressed as a *logical (identifier-based) reference* by populating `Reference.identifier` with the actor's business identifier — typically the NPI (`http://hl7.org/fhir/sid/us-npi`) for Practitioner, PractitionerRole, or Organization actors — together with `Reference.display` for human readability, so that the source/payer system can match the actor against its own records without resolving a FHIR resource reference relative to the requester's system. Alternatively, the reference MAY point to a `contained` resource that itself carries the business identifier.",
"mustSupport": true
}, {
"id": "Consent.provision.purpose",
"path": "Consent.provision.purpose",
"short": "Purpose of accessing patient information",
"binding": {
"strength": "extensible",
"valueSet": "http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0"
},
"definition": "The purpose(s) for which the treatment relationship allows access to patient information (e.g., treatment, care coordination, quality improvement)",
"mustSupport": true
} ]
},
"contact": [ {
"name": "HL7 International / Financial Management",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/fm",
"system": "url"
}, {
"value": "fm@lists.HL7.org",
"system": "email"
} ]
}, {
"name": "Mark Scrimshire (mark.scrimshire@onyxhealth.io)",
"telecom": [ {
"value": "mailto:mark.scrimshire@onyxhealth.io",
"system": "email"
} ]
}, {
"name": "HL7 International - Financial Management",
"telecom": [ {
"value": "http://www.hl7.org/Special/committees/fm",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Consent"
}