Narrativa gerada: StructureDefinition AppointmentBRIPES Nome Bandeiras Card. Tipo Descrição e condicionalismos<img src="[binary]" alt="doco" style="background-color: inherit"/> Appointment Appointment #xD; meta #xD; Fatias para tag 0..* Coding Tags applied to this resource Fatia: Não ordenado, Aberto por pattern:$this #xD; tag:estabelecimentoExecutante 0..1 Coding Tags applied to this resource #xD; system 1..1 uri Identity of the terminology system Valor fixo: http://fhir.ipes.tech/fhir/StructureDefinition/EstabelecimentoExecutante #xD; code 1..1 code CNES do estabelecimento executante #xD; Fatias para contained 2..* Resource Contained, inline Resources Fatia: Não ordenado, Aberto por pattern:$this #xD; contained:organization 0..1 Organization Contained, inline Resources #xD; identifier 1..1 Identifier Identifies this organization across multiple systems #xD; active 0..0 #xD; type 0..0 #xD; alias 0..1 string A list of alternate names that the organization is known as, or was known as in the past #xD; telecom 0..0 #xD; address 0..0 #xD; partOf 0..0 #xD; contact 0..0 #xD; endpoint 0..0 #xD; contained:healthcareService 1..1 HealthcareService Serviço de saúde #xD; providedBy #xD; reference 1..1 string Literal reference, Relative, internal or absolute URL #xD; category 0..0 #xD; type 0..0 #xD; specialty 0..0 #xD; location 1..1 Reference(Location) Location(s) where service may be provided #xD; reference 0..1 string Literal reference, Relative, internal or absolute URL Valor fixo: location1 #xD; type 0..0 #xD; identifier 0..0 #xD; comment 0..0 #xD; extraDetails 0..0 #xD; photo 0..0 #xD; telecom 0..0 #xD; coverageArea 0..0 #xD; serviceProvisionCode 0..0 #xD; eligibility 0..0 #xD; program 0..0 #xD; characteristic 0..0 #xD; communication 0..0 #xD; referralMethod 0..0 #xD; appointmentRequired 0..0 #xD; availableTime 0..0 #xD; notAvailable 0..0 #xD; availabilityExceptions 0..0 #xD; endpoint 0..0 #xD; contained:location 1..1 Location Contained, inline Resources #xD; identifier 0..0 #xD; status 0..0 #xD; operationalStatus 0..0 #xD; alias 0..1 string A list of alternate names that the location is known as, or was known as, in the past #xD; mode 0..0 #xD; type 0..0 #xD; telecom #xD; system 1..1 code phone | fax | email | pager | url | sms | other Valor fixo: phone #xD; value 1..1 string The actual contact point details #xD; address 1..1 Address Physical location #xD; physicalType 0..0 #xD; managingOrganization 0..0 #xD; partOf 0..0 #xD; availabilityExceptions 0..0 #xD; endpoint 0..0 #xD; contained:practitioner 0..1 Practitioner Contained, inline Resources #xD; active 0..0 #xD; name 0..1 HumanName The name(s) associated with the practitioner #xD; telecom 0..0 #xD; address 0..0 #xD; gender 0..0 #xD; birthDate 0..0 #xD; photo 0..0 #xD; qualification 0..0 #xD; communication 0..0 #xD; Fatias para identifier 1..1 Identifier External Ids for this item Fatia: Não ordenado, Aberto por pattern:system #xD; identifier:localIdentifier 1..1 Identifier Identificador do registro no sistema de origem #xD; use 0..0 #xD; type 0..0 #xD; system 1..1 uri Identificador único do sistema de origem #xD; value 1..1 string Identificador do registro no sistema de origem #xD; period 0..0 #xD; assigner 0..0 #xD; serviceCategory 0..1 CodeableConcept A broad categorization of the service that is to be performed during this appointment Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRModalidadeAssistencial (preferred) #xD; serviceType 0..* CodeableConcept Procedimento(s) agendado(s) Vínculo: ServiceType (preferred): https://terminologia.saude.gov.br/fhir/ValueSet/BRProcedimentosNacionais #xD; Fatias para specialty 0..* CodeableConcept The specialty of a practitioner that would be required to perform the service requested in this appointment Fatia: Não ordenado, Aberto por pattern:$this #xD; specialty:specialty 0..1 CodeableConcept The specialty of a practitioner that would be required to perform the service requested in this appointment Vínculo: Especialidade (preferred) #xD; specialty:specialtyDetail 0..1 CodeableConcept The specialty of a practitioner that would be required to perform the service requested in this appointment Vínculo: Área de Atuação (preferred) #xD; specialty:cbo 0..1 CodeableConcept The specialty of a practitioner that would be required to perform the service requested in this appointment Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BROcupacao (required) #xD; reasonCode 0..* CodeableConcept Coded reason this appointment is scheduled Vínculo: https://terminologia.saude.gov.br/fhir/ValueSet/BRProblemaDiagnostico (preferred) #xD; reasonReference 0..0 #xD; priority 0..0 #xD; supportingInformation 0..0 #xD; start 1..1 instant When appointment is to take place #xD; basedOn 0..* Reference(Solicitação de Serviço | Solicitação de Serviço) The service request this appointment is allocated to assess #xD; type 0..0 #xD; identifier 0..0 #xD; display 0..0 #xD; Fatias para participant 2..* BackboneElement Participants involved in appointment Fatia: Não ordenado, Aberto por pattern:$this #xD; participant:patient 1..1 BackboneElement Participants involved in appointment #xD; type 1..1 CodeableConcept Role of participant in the appointment Valor fixo: Como mostrado (subject) #xD; coding 1..1 Coding Code defined by a terminology system Valor fixo: (complexo) #xD; system 1..1 uri Identity of the terminology system Valor fixo: http://terminology.hl7.org/CodeSystem/v3-ParticipationType #xD; code 1..1 code Symbol in syntax defined by the system Valor fixo: SBJ #xD; coding 1..1 Coding Code defined by a terminology system #xD; actor 1..1 Reference(Paciente) Person, Location/HealthcareService or Device #xD; reference 1..1 string Literal reference, Relative, internal or absolute URL #xD; type 0..0 #xD; identifier 0..0 #xD; display 0..0 #xD; required 0..0 #xD; period 0..0 #xD; participant:healthcareService 1..1 BackboneElement Participants involved in appointment #xD; type 1..1 CodeableConcept Role of participant in the appointment Valor fixo: Como mostrado (primary performer) #xD; coding 1..1 Coding Code defined by a terminology system Valor fixo: (complexo) #xD; system 1..1 uri Identity of the terminology system Valor fixo: http://terminology.hl7.org/CodeSystem/v3-ParticipationType #xD; code 1..1 code Symbol in syntax defined by the system Valor fixo: PPRF #xD; actor 1..1 Reference(HealthcareService) Person, Location/HealthcareService or Device #xD; required 0..0 #xD; period 0..0 #xD; participant:practitioner 0..1 BackboneElement Participants involved in appointment #xD; type 1..1 CodeableConcept Role of participant in the appointment Valor fixo: Como mostrado (primary performer) #xD; coding 1..1 Coding Code defined by a terminology system Valor fixo: (complexo) #xD; system 1..1 uri Identity of the terminology system Valor fixo: http://terminology.hl7.org/CodeSystem/v3-ParticipationType #xD; code 1..1 code Symbol in syntax defined by the system Valor fixo: PPRF #xD; actor 1..1 Reference(Practitioner) Person, Location/HealthcareService or Device #xD; requestedPeriod 0..0 #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentação para este formato
A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s).
Either start and end are specified, or neither
((exists(f:start) and exists(f:end)) or (not(exists(f:start)) and not(exists(f:end))))
Only proposed or cancelled appointments can be missing start/end dates
(start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
((exists(f:start) and exists(f:end)) or (f:status/@value='proposed') or (f:status/@value='cancelled') or (f:status/@value='waitlist'))
Cancelation reason is only used for appointments that have been cancelled, or no-show
Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
not(exists(f:cancellationReason)) or f:status/@value=('no-show', 'cancelled')
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
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='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
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.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
When the resource last changed - e.g. when the version changed.
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R4/http.html#read) interaction.
Identifies where the resource comes from
A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Security Labels from the Healthcare Privacy and Security Classification System.
Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
The identification of the code system that defines the meaning of the symbol in the code.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
A set of rules under which this content was created
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.
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.
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
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
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.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
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.
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.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Identifies this organization across multiple systems
Identifier for the organization that is used to identify the organization across multiple disparate systems.
Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.
Whether the organization's record is still in active use
Whether the organization's record is still in active use.
This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used. This element is labeled as a modifier because it may be used to mark that the resource was created in error.
Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.
This resource is generally assumed to be active if no value is provided for the active element
This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
./Status (however this concept in ServD more covers why the organization is active or not, could be delisted, deregistered, not operational yet) this could alternatively be derived from ./StartDate and ./EndDate and given a context date.
The kind(s) of organization that this is.
Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center. We expect that some jurisdictions will profile this optionality to be a single cardinality.
Need to be able to track the kind of organization that this is - different organization types have different uses.
A name associated with the organization.
If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.
Need to use the name as the label of the organization.
A list of alternate names that the organization is known as, or was known as in the past
A list of alternate names that the organization is known as, or was known as in the past.
There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.
Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the organization was known by can be very useful.
The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.
The telecom of an organization can never be of use 'home'
Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used.
May need to keep track of the organization's addresses for contacting, billing or reporting requirements.
An address of an organization can never be of use 'home'
The organization of which this organization forms a part
The organization of which this organization forms a part.
Need to be able to track the hierarchy of organizations within an organization.
Contact for the organization for a certain purpose
Contact for the organization for a certain purpose.
Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.
Need to keep track of assigned contact points within bigger organization.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Indicates a purpose for which the contact can be reached.
Need to distinguish between multiple contact persons.
The purpose for which you would contact a contact party.
Need to be able to track the person by name.
Contact details (telephone, email, etc.) for a contact
A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.
People have (primary) ways to contact them in some way such as phone, email.
Visiting or postal addresses for the contact
Visiting or postal addresses for the contact.
May need to keep track of a contact party's address for contacting, billing or reporting requirements.
Technical endpoints providing access to services operated for the organization
Technical endpoints providing access to services operated for the organization.
Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.
Whether this HealthcareService record is in active use
This flag is used to mark the record to not be used. This is not used when a center is closed for maintenance, or for holidays, the notAvailable period is to be used for this.
This element is labeled as a modifier because it may be used to mark that the resource was created in error.
The organization that provides this healthcare service.
This property is recommended to be the same as the Location's managingOrganization, and if not provided should be interpreted as such. If the Location does not have a managing Organization, then this property should be populated.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
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.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Broad category of service being performed or delivered
Identifies the broad category of service being performed or delivered.
Selecting a Service Category then determines the list of relevant service types that can be selected in the primary service type.
A category of the service(s) that could be provided.
Type of service that may be delivered or performed
The specific type of service that may be delivered or performed.
Additional details about where the content was created (e.g. clinical specialty).
Specialties handled by the HealthcareService
Collection of specialties handled by the service site. This is more of a medical term.
A specialty that a healthcare service may provide.
Location(s) where service may be provided
The location(s) where this healthcare service may be provided.
Description of service as presented to a consumer while searching
Further description of the service as it would be presented to a consumer while searching.
Additional description and/or any specific issues not covered elsewhere
Any additional description of the service and/or any specific issues not covered by the other attributes, which can be displayed as further detail under the serviceName.
Would expect that a user would not see this information on a search results, and it would only be available when viewing the complete details of the service.
Extra details about the service that can't be placed in the other fields
Extra details about the service that can't be placed in the other fields.
Facilitates quick identification of the service
If there is a photo/symbol associated with this HealthcareService, it may be included here to facilitate quick identification of the service in a list.
Contacts related to the healthcare service
List of contacts related to this specific healthcare service.
If this is empty, then refer to the location's contacts.
Location(s) service is intended for/available to
The location(s) that this service is available to (not where the service is provided).
The locations referenced by the coverage area can include both specific locations, including areas, and also conceptual domains too (mode = kind), such as a physical area (tri-state area) and some other attribute (covered by Example Care Organization). These types of Locations are often not managed by any specific organization. This could also include generic locations such as "in-home".
Conditions under which service is available/offered
The code(s) that detail the conditions under which the healthcare service is available/offered.
The provision means being commissioned by, contractually obliged or financially sourced. Types of costings that may apply to this healthcare service, such if the service may be available for free, some discounts available, or fees apply.
Specific eligibility requirements required to use the service
Does this service have specific eligibility requirements that need to be met in order to use the service?
Coded values underwhich a specific service is made available.
Describes the eligibility conditions for the service
Describes the eligibility conditions for the service.
The description of service eligibility should, in general, not exceed one or two paragraphs. It should be sufficient for a prospective consumer to determine if they are likely to be eligible or not. Where eligibility requirements and conditions are complex, it may simply be noted that an eligibility assessment is required. Where eligibility is determined by an outside source, such as an Act of Parliament, this should be noted, preferably with a reference to a commonly available copy of the source document such as a web page.
Programs that this service is applicable to
Programs that this service is applicable to.
Programs are often defined externally to an Organization, commonly by governments; e.g. Home and Community Care Programs, Homeless Program, ….
Government or local programs that this service applies to.
Collection of characteristics (attributes)
Collection of characteristics (attributes).
These could be such things as is wheelchair accessible.
A custom attribute that could be provided at a service (e.g. Wheelchair accessibiliy).
The language that this service is offered in
Some services are specifically made available in multiple languages, this property permits a directory to declare the languages this is offered in. Typically this is only provided where a service operates in communities with mixed languages used.
When using this property it indicates that the service is available with this language, it is not derived from the practitioners, and not all are required to use this language, just that this language is available while scheduling.
Ways that the service accepts referrals, if this is not provided then it is implied that no referral is required.
The methods of referral can be used when referring to a specific HealthCareService resource.
If an appointment is required for access to this service
Indicates whether or not a prospective consumer will require an appointment for a particular service at a site to be provided by the Organization. Indicates if an appointment is required for access to this service.
A collection of times that the Service Site is available.
More detailed availability information may be provided in associated Schedule/Slot resources.
Indicates which days of the week are available between the start and end Times.
Is this always available? (hence times are irrelevant) e.g. 24 hour service.
Opening time of day (ignored if allDay = true)
The opening time of day. Note: If the AllDay flag is set, then this time is ignored.
The time zone is expected to be for where this HealthcareService is provided at.
Closing time of day (ignored if allDay = true)
The closing time of day. Note: If the AllDay flag is set, then this time is ignored.
Not available during this time due to provided reason
The HealthcareService is not available during this period of time due to the provided reason.
Reason presented to the user explaining why time not available
The reason that can be presented to the user as to why this time is not available.
Service is not available (seasonally or for a public holiday) from this date.
A description of site availability exceptions, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as details in the available Times and not available Times.
Technical endpoints providing access to electronic services operated for the healthcare service
Technical endpoints providing access to services operated for the specific healthcare services defined at this resource.
Unique code or number identifying the location to its users
Unique code or number identifying the location to its users.
Organization label locations in registries, need to keep track of those.
The status property covers the general availability of the resource, not the current value which may be covered by the operationStatus, or by a schedule/slots if they are configured for the location.
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid
Indicates whether the location is still in use.
The operational status of the location (typically only for a bed/room)
The operational status covers operation values most relevant to beds (but can also apply to rooms/units/chairs/etc. such as an isolation unit/dialysis chair). This typically covers concepts such as contamination, housekeeping, and other activities like maintenance.
The operational status if the location (where typically a bed/room).
Name of the location as used by humans. Does not need to be unique.
If the name of a location changes, consider putting the old name in the alias column so that it can still be located through searches.
A list of alternate names that the location is known as, or was known as, in the past
A list of alternate names that the location is known as, or was known as, in the past.
There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the location.
Over time locations and organizations go through many changes and can be known by different names. For searching knowing previous names that the location was known by can be very useful.
Additional details about the location that could be displayed as further information to identify the location beyond its name
Description of the Location, which helps in finding or referencing the place.
Humans need additional information to verify a correct location has been identified.
.playingEntity[classCode=PLC determinerCode=INSTANCE].desc
Indicates whether a resource instance represents a specific location or a class of locations.
This is labeled as a modifier because whether or not the location is a class of locations changes how it can be used and understood.
When using a Location resource for scheduling or orders, we need to be able to refer to a class of Locations instead of a specific Location.
Indicates the type of function performed at the location.
The contact details of communication devices available at the location. This can include phone numbers, fax numbers, mobile numbers, email addresses and web sites.
phone | fax | email | pager | url | sms | other
Telecommunications form for contact point - what communications system is required to make use of the contact.
Telecommunications form for contact point.
The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Need to support legacy numbers that are not in a tightly controlled format.
home | work | temp | old | mobile - purpose of this contact point
Identifies the purpose for the contact point.
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Specify preferred order of use (1 = highest)
Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Time period when the contact point was/is in use
Time period when the contact point was/is in use.
Additional addresses should be recorded using another instance of the Location resource, or via the Organization.
If locations can be visited, we need to keep track of their address.
Physical form of the location, e.g. building, room, vehicle, road.
For purposes of showing relevant locations in queries, we need to categorize locations.
The absolute geographic location of the Location, expressed using the WGS84 datum (This is the same co-ordinate system used in KML).
For mobile applications and automated route-finding knowing the exact location of the Location is required.
.playingEntity [classCode=PLC determinerCode=INSTANCE].positionText
Longitude. The value domain and the interpretation are the same as for the text of the longitude element in KML (see notes below).
(RIM Opted not to map the sub-elements of GPS location, is now an OBS)
Latitude. The value domain and the interpretation are the same as for the text of the latitude element in KML (see notes below).
Altitude. The value domain and the interpretation are the same as for the text of the altitude element in KML (see notes below).
Organization responsible for provisioning and upkeep
The organization responsible for the provisioning and upkeep of the location.
This can also be used as the part of the organization hierarchy where this location provides services. These services can be defined through the HealthcareService resource.
.scopingEntity[classCode=ORG determinerKind=INSTANCE]
Another Location this one is physically a part of
Another Location of which this Location is physically a part of.
For purposes of location, display and identification, knowing which locations are located within other locations is important.
What days/times during a week is this location usually open
What days/times during a week is this location usually open.
This type of information is commonly found published in directories and on websites informing customers when the facility is available. Specific services within the location may have their own hours which could be shorter (or longer) than the locations hours.
A description of when the locations opening ours are different to normal, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as detailed in the opening hours Times.
Technical endpoints providing access to services operated for the location
Technical endpoints providing access to services operated for the location.
Organizations may have different systems at different locations that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.
An identifier for the person as this agent
An identifier that applies to this person in this role.
Often, specific identities are assigned for the agent.
Whether this practitioner's record is in active use
Whether this practitioner's record is in active use.
If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.
Need to be able to mark a practitioner record as not to be used because it was created in error.
The name(s) associated with the practitioner
The name(s) associated with the practitioner.
The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate. In general, select the value to be used in the ResourceReference.display based on this: 1. There is more than 1 name 2. Use = usual 3. Period is current to the date of the usage 4. Use = official 5. Other order as decided by internal business rules.
The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.
./PreferredName (GivenNames, FamilyName, TitleCode)
A contact detail for the practitioner (that apply to all roles)
A contact detail for the practitioner, e.g. a telephone number or an email address.
Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.
Need to know how to reach a practitioner independent to any roles the practitioner may have.
Address(es) of the practitioner that are not role specific (typically home address)
Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.
The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).
The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.
Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.
The gender of a person used for administrative purposes.
The date on which the practitioner was born
Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.
./ImageURI (only supports the URI reference)
Certification, licenses, or training pertaining to the provision of care
The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.
An identifier for this qualification for the practitioner
An identifier that applies to this person's qualification in this role.
Often, specific identities are assigned for the qualification.
Coded representation of the qualification
Coded representation of the qualification.
Specific qualification the practitioner has to provide a service.
Period during which the qualification is valid
Period during which the qualification is valid.
Qualifications are often for a limited period of time, and can be revoked.
./Qualifications.StartDate and ./Qualifications.EndDate
Organization that regulates and issues the qualification
Organization that regulates and issues the qualification.
A language the practitioner can use in patient communication
A language the practitioner can use in patient communication.
The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
Knowing which language a practitioner speaks can help in facilitating communication with patients.
This records identifiers associated with this appointment concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
Identificador do registro no sistema de origem
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Identificador único do sistema de origem
URL ou OID da instância/sistema de origem - fornecido pela plataforma.
Identifier.system is always case sensitive.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Time period when id is/was valid for use
Time period during which identifier is/was valid for use.
Role.effectiveTime or implied by context
Organization that issued id (may be just text)
Organization that issued/manages the identifier.
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
The overall status of the Appointment. Each of the participants has their own participation status which indicates their involvement in the process, however this status indicates the shared status.
If the Appointment's status is "cancelled" then all participants are expected to have their calendars released for the appointment period, and as such any Slots that were marked as BUSY can be re-set to FREE. This element is labeled as a modifier because the status contains the code entered-in-error that mark the Appointment as not currently valid.
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
The coded reason for the appointment being cancelled
The coded reason for the appointment being cancelled. This is often used in reporting/billing/futher processing to determine if further actions are required, or specific fees apply.
A broad categorization of the service that is to be performed during this appointment
A broad categorization of the service that is to be performed during this appointment.
n/a, might be inferred from the ServiceDeliveryLocation
The specific service that is to be performed during this appointment.
For a provider to provider appointment the code "FOLLOWUP" may be appropriate, as this is expected to be discussing some patient that was seen in the past.
The specialty of a practitioner that would be required to perform the service requested in this appointment
The specialty of a practitioner that would be required to perform the service requested in this appointment.
The style of appointment or patient that has been booked in the slot (not service type)
The style of appointment or patient that has been booked in the slot (not service type).
Coded reason this appointment is scheduled
The coded reason that this appointment is being scheduled. This is more clinical than administrative.
Reason the appointment is to take place (resource)
Reason the appointment has been scheduled to take place, as specified using information from another resource. When the patient arrives and the encounter begins it may be used as the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.
.inboundRelationship[@typeCode = 'RSON'].observation
Used to make informed decisions if needing to re-prioritize
The priority of the appointment. Can be used to make informed decisions if needing to re-prioritize appointments. (The iCal Standard specifies 0 as undefined, 1 as highest, 9 as lowest priority).
Seeking implementer feedback on this property and how interoperable it is. Using an extension to record a CodeableConcept for named values may be tested at a future connectathon.
Shown on a subject line in a meeting request, or appointment list
The brief description of the appointment as would be shown on a subject line in a meeting request, or appointment list. Detailed or expanded information should be put in the comment field.
Additional information to support the appointment
Additional information to support the appointment provided when making the appointment.
.inboundRelationship[@typeCode = 'SPRT'].observation
Date/Time that the appointment is to take place.
Date/Time that the appointment is to conclude.
SCH-11.5 / TQ1-8/ calculated based on the start and the duration which is in ARQ-9
Can be less than start/end (e.g. estimate)
Number of minutes that the appointment is to take. This can be less than the duration between the start and end times. For example, where the actual time of appointment is only an estimate or if a 30 minute appointment is being requested, but any time would work. Also, if there is, for example, a planned 15 minute break in the middle of a long appointment, the duration may be 15 minutes less than the difference between the start and end.
.activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')].width
The slots that this appointment is filling
The slots from the participants' schedules that will be filled by the appointment.
.outboundRelationship[@typeCode = 'REFR'].act[@classCode = 'ACT'][@moodCode = 'SLOT']
The date that this appointment was initially created
The date that this appointment was initially created. This could be different to the meta.lastModified value on the initial entry, as this could have been before the resource was created on the FHIR server, and should remain unchanged over the lifespan of the appointment.
This property is required for many use cases where the age of an appointment is considered in processing workflows for scheduling and billing of appointments.
Additional comments about the appointment.
Additional text to aid in facilitating the appointment. For instance, a comment might be, "patient should proceed immediately to infusion room upon arrival" Where this is a planned appointment and the start/end dates are not set then this field can be used to provide additional guidance on the details of the appointment request, including any restrictions on when to book it.
.subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value
Detailed information and instructions for the patient
While Appointment.comment contains information for internal use, Appointment.patientInstructions is used to capture patient facing information about the Appointment (e.g. please bring your referral or fast from 8pm night before).
The service request this appointment is allocated to assess
The service request this appointment is allocated to assess (e.g. incoming referral or procedure request).
.outboundRelationship[@typeCode = 'FLFS'].act[@classCode < 'ActCareProvisionRequestType'][@moodCode = 'RQO']
List of participants involved in the appointment.
Either the type or actor on the participant SHALL be specified
performer | reusableDevice | subject | location
The role of the participant can be used to declare what the actor will be doing in the scope of this appointment. If the actor is not specified, then it is expected that the actor will be filled in at a later stage of planning. This value SHALL be the same when creating an AppointmentResponse so that they can be matched, and subsequently update the Appointment.
(performer | reusableDevice | subject | location).@typeCode
Person, Location/HealthcareService or Device
A Person, Location/HealthcareService or Device that is participating in the appointment.
PID-3-Patient ID List | AIL-3 | AIG-3 | AIP-3
performer.person | reusableDevice.manufacturedDevice | subject.patient | location.serviceDeliveryLocation
ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
Whether this participant is required to be present at the meeting. This covers a use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.
Is the Participant required to attend the appointment.
(performer | reusableDevice | subject | location).@performInd
accepted | declined | tentative | needs-action
The Participation status of an appointment.
(performer | reusableDevice | subject | location).statusCode
ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam | partstatparam)
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Potential date/time interval(s) requested to allocate the appointment within
A set of date ranges (potentially including times) that the appointment is preferred to be scheduled within. The duration (usually in minutes) could also be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time. However, in other situations the duration may be calculated by the scheduling system.
This does not introduce a capacity for recurring appointments.
.activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')]