Canadian Baseline
1.1.0 - CI Build Canada flag

Canadian Baseline, published by HL7 Canada - FHIR Implementation Work Group. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-Canada/ca-baseline/ and changes regularly. See the Directory of published versions

Resource Profile: Practitioner Profile (Provider Registry)

Official URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-practitioner-registry Version: 1.1.0
Draft as of 2022-09-28 Computable Name: PractitionerProfileRegistry

Proposed constraints and extensions on the Practitioner Resource for use by Provider Registry systems

CA Baseline Practitioner Profile for Registries

While the CA Baseline relies on the existing extensible value set for identifier.type (from the base FHIR Spec) - some Canadian Jurisdictions have published the values that are extensions on that value set. Review of the Ontario Provider Registry Identifier.Type ValueSet.identified that the following Ontario specific identifier type codes may be used from the http://ehealthontario.ca/fhir/CodeSystem/ppr-organization-identifier-type code system: LHIN (Local Health Integration Network), MNI (Master Numbering Index), LSS (Lab Services Licensing System, CNUM (Corporate Number), BNUM (Business Number), AC (Accreditation Number).

The CA Baseline is asking other jurisdictions or implementers to provide feedback if other values are being used for identifier.type not already discussed in this profile

For Practitioner.qualification, slicing has been maintained to demonstrate that there are some registries supporting hybridized registry/eReferral use cases that utilize a different code system (HealthcareProviderRoleType) from the QualifiedRoleType that was incorporated by many HL7 V3 implementations. This separation based on use case and age of implementation remains a challenge in the Canadian ecosystem, and has persisted in part due to the challenges some registry assets face in consuming the longer character lengths present in the SNOMED CT CA HealthcareProviderRoleType value set. Until practices are more standardized or a resolution is in place regarding the disparate use of these two code systems, implementers are cautioned that the CA Baseline's use of these code systems and value sets still may change.

The CA Baseline is asking implementers to provide feedback on the value sets and code systems they are expecting to utilize as they transition to FHIR .


Feedback can be provided through the Simplifier issue log for this profile.

This Practitioner profile sets minimum expectations for the Practitioner resource to record, search and fetch demographics and other administrative information about a person who is directly or indirectly involved in the provisioning of healthcare.

This profile further constrains the general purpose Practitioner profile and is intended to be used by Provider or Healthcare Directory systems.

Differences from US Core

Note: This profile was generated from HL7 StructureDefinition on 2020-02-19 and constrained during a review of US Core against Canadian sources.

Mandatory Data Elements

All elements or attributes defined in FHIR have cardinality as part of their definition - a minimum number of required appearances and a maximum number.

Most elements in FHIR specification have a minimum cardinality of 0, which means that they may be missing from a resource when it is exchanged between systems.

Required elements:

  • a identifier
  • a practitioner name

In addition to that, some optional elements (e.g., Practitioner.qualification) have required components that MUST be present if that optional element is provided.

Data Absent Reason

In situations where the minimum cardinality of an element or attribute is 1 and information is missing and the Responder knows the precise reason for the absence of data, Responders SHALL send the reason for the missing information using values (such as NullFlavor) from the value set where they exist or using the DataAbsentReason extension.

Must Support Data Elements

Some elements are labeled as MustSupport meaning that implementations that produce or consume resources SHALL provide "support" for the element in some meaningful way (see Must Support definition).

Following elements are marked as Must Support in the Practitioner profile to aid record matching in databases with many pediatric records.

Must Support elements:

  • an identifier
  • a practitioner name
  • contact detail (e.g. a telephone number or an email address)
  • a birth date

Extensions

Deceased Extension

This Practitioner profile contains optional deceased extension to indicate if a practitioner is deceased or not.

This extension was previously labeled as a modifier extension (because of its potential impacts on clinical processes if the practitioner is marked deceased), but was removed after further discussion on the nuances of making something a modifierExtension vs regular extension if it was expected to be picked up by registry implementation guides that collect deceased practitioner information but may or may not use it in ways that would align to HL7 FHIR R4 definition and expectations for modifierExtension.

Implementers should recognize that the determination of whether this should be considered a modifierExtension is ongoing. Since Modifier Extensions should have extreme caution in their application and are further nuanced by the use cases in the implementing registry systems, this extension has been shifted back to a regular extension to align to use in existing implementations. Implementers who are considering using this extension in their guidance might consider applying a Must Support flag on the extension, but those treating wanting to re-create it as a modifier extension are required to review the [FHIR Guidance on Modifier Extensions])(https://www.hl7.org/fhir/R4/extensibility.html#modifierExtension) before including this extension in their profile. Implementers should also be aware of the Practitioner.deceased[x] R5 concept and that the CA Baseline is monitoring changes in the element to determine if the approach to this extension requires a shift.

Usage Note

This Practitioner profile is intended to provide a foundation for a central or distributed Provider or Healthcare Directory. Additional work flow components and elements may be required for a particular implementation.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from PractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* PractitionerProfile Practitioner Profile
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... deceased 0..1 boolean, date Indicates if the individual is deceased or not.
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
... identifier S 1..* IdentifierCABaseline An identifier intended for computation
... name S 1..* HumanName The name(s) associated with the practitioner
... address
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
... birthDate S 0..1 date The date on which the practitioner was born
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... code
..... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
...... coding:All Slices Content/Rules for all slices
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
...... coding:Registry 0..* Coding Code defined by a terminology system
....... system 1..1 uri QualifiedRoleType
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
...... coding:eReferral 0..* Coding Code defined by a terminology system
....... system 1..1 uri HealthcareProviderRoleType
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* PractitionerProfile Practitioner Profile
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... deceased 0..1 boolean, date Indicates if the individual is deceased or not.
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... name SΣC 1..* HumanName The name(s) associated with the practitioner
ele-1: All FHIR elements must have a @value or children
ca-baseline-practitioner-name: Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.


ele-1: All FHIR elements must have a @value or children
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
ele-1: All FHIR elements must have a @value or children
... birthDate SΣ 0..1 date The date on which the practitioner was born
ele-1: All FHIR elements must have a @value or children
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.


ele-1: All FHIR elements must have a @value or children
..... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
ele-1: All FHIR elements must have a @value or children
...... coding:All Slices Content/Rules for all slices
....... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
....... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
...... coding:Registry Σ 0..* Coding Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children
....... system Σ 1..1 uri QualifiedRoleType
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
...... coding:eReferral Σ 0..* Coding Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children
....... system Σ 1..1 uri HealthcareProviderRoleType
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-practitioner-nameerrorPractitioner.nameEither name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
: (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* PractitionerProfile Practitioner Profile
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... deceased 0..1 boolean, date Indicates if the individual is deceased or not.
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 1..* IdentifierCABaseline An identifier intended for computation
... active Σ 0..1 boolean Whether this practitioner's record is in active use
... name SΣC 1..* HumanName The name(s) associated with the practitioner
ca-baseline-practitioner-name: Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ 0..1 string Text representation of the full name
.... family ΣC 0..1 string Family name (often called 'Surname')
.... given ΣC 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period Time period when name was/is in use
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
... address Σ 0..* Address Address(es) of the practitioner that are not role specific (typically home address)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line Σ 0..* string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city Σ 0..1 string Name of city, town etc.
Example General: Erewhon
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state Σ 0..1 string Sub-unit of country (abbreviations ok)
.... postalCode Σ 0..1 string Postal code for area
Example General: 9132
.... country Σ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate SΣ 0..1 date The date on which the practitioner was born
... photo 0..* Attachment Image of the person
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier 0..* Identifier An identifier for this qualification for the practitioner
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
...... coding:All Slices Content/Rules for all slices
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:Registry Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri QualifiedRoleType
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 0..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:eReferral Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri HealthcareProviderRoleType
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 0..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... period 0..1 Period Period during which the qualification is valid
.... issuer 0..1 Reference(Organization) Organization that regulates and issues the qualification
... communication 0..* CodeableConcept A language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
from the FHIR Standard
Practitioner.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
from the FHIR Standard
Practitioner.communicationpreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-practitioner-nameerrorPractitioner.nameEither name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
: (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from PractitionerProfile

Summary

Mandatory: 2 elements(4 nested mandatory elements)
Must-Support: 4 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Practitioner.qualification.code.coding

Differential View

This structure is derived from PractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* PractitionerProfile Practitioner Profile
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... deceased 0..1 boolean, date Indicates if the individual is deceased or not.
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
... identifier S 1..* IdentifierCABaseline An identifier intended for computation
... name S 1..* HumanName The name(s) associated with the practitioner
... address
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
... birthDate S 0..1 date The date on which the practitioner was born
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... code
..... Slices for coding 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
...... coding:All Slices Content/Rules for all slices
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
...... coding:Registry 0..* Coding Code defined by a terminology system
....... system 1..1 uri QualifiedRoleType
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
...... coding:eReferral 0..* Coding Code defined by a terminology system
....... system 1..1 uri HealthcareProviderRoleType
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* PractitionerProfile Practitioner Profile
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... deceased 0..1 boolean, date Indicates if the individual is deceased or not.
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... name SΣC 1..* HumanName The name(s) associated with the practitioner
ele-1: All FHIR elements must have a @value or children
ca-baseline-practitioner-name: Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.


ele-1: All FHIR elements must have a @value or children
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
ele-1: All FHIR elements must have a @value or children
... birthDate SΣ 0..1 date The date on which the practitioner was born
ele-1: All FHIR elements must have a @value or children
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.


ele-1: All FHIR elements must have a @value or children
..... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
ele-1: All FHIR elements must have a @value or children
...... coding:All Slices Content/Rules for all slices
....... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
....... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
...... coding:Registry Σ 0..* Coding Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children
....... system Σ 1..1 uri QualifiedRoleType
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
...... coding:eReferral Σ 0..* Coding Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children
....... system Σ 1..1 uri HealthcareProviderRoleType
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-practitioner-nameerrorPractitioner.nameEither name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
: (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* PractitionerProfile Practitioner Profile
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... deceased 0..1 boolean, date Indicates if the individual is deceased or not.
URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier S 1..* IdentifierCABaseline An identifier intended for computation
... active Σ 0..1 boolean Whether this practitioner's record is in active use
... name SΣC 1..* HumanName The name(s) associated with the practitioner
ca-baseline-practitioner-name: Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ 0..1 string Text representation of the full name
.... family ΣC 0..1 string Family name (often called 'Surname')
.... given ΣC 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period Time period when name was/is in use
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
... address Σ 0..* Address Address(es) of the practitioner that are not role specific (typically home address)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... preferred 0..1 boolean HL7 Preferred Address Flag extension
URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line Σ 0..* string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city Σ 0..1 string Name of city, town etc.
Example General: Erewhon
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state Σ 0..1 string Sub-unit of country (abbreviations ok)
.... postalCode Σ 0..1 string Postal code for area
Example General: 9132
.... country Σ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate SΣ 0..1 date The date on which the practitioner was born
... photo 0..* Attachment Image of the person
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier 0..* Identifier An identifier for this qualification for the practitioner
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ 0..* Coding Code defined by a terminology system
Slice: Unordered, Open by pattern:system
...... coding:All Slices Content/Rules for all slices
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:Registry Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri QualifiedRoleType
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 0..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... coding:eReferral Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri HealthcareProviderRoleType
Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 0..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... period 0..1 Period Period during which the qualification is valid
.... issuer 0..1 Reference(Organization) Organization that regulates and issues the qualification
... communication 0..* CodeableConcept A language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
from the FHIR Standard
Practitioner.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
from the FHIR Standard
Practitioner.communicationpreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding

Constraints

IdGradePath(s)DetailsRequirements
ca-baseline-practitioner-nameerrorPractitioner.nameEither name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
: (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
dom-2errorPractitionerIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorPractitionerIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorPractitionerIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practicePractitionerA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from PractitionerProfile

Summary

Mandatory: 2 elements(4 nested mandatory elements)
Must-Support: 4 elements
Fixed: 2 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Practitioner.qualification.code.coding

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Identifiers

Multiple types of provider identifiers may be used in Practitioner.identifier element in the Canadian context:

  • Provincial health plan provider/ Billing number
  • Licence Number
  • Medical Doctor Number

Implementers may use other identifiers to capture in a more specific way such as internal provider number, jurisdictions providing credentials. The full list of possible identifier types is in Canadian URI Registry

In some cases, the same license number can be used as the provider identifier and provider's qualification identifier.

Telecom

A provider may have multiple ways to be contacted with different uses or applicable periods. This Practitioner profile allows multiple contact points (e.g. a telephone number or an email address) by which the individual may be contacted.

To indicate the preferred way to contact use Practitioner.telecom.rank attribute (i.e., the ContactPoint.rank component) that 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.

Address

The Practitioner profile is provided for use in a Canadian context where some constraint on content is desirable to guarantee the quality of the Canadian address whilst still supporting other type of address (e.g., other countries or UNstructured addresses).

Canadian postal code

If an address in the Practitioner resource instance represents Canadian address, it SHOULD follow Canadian postal code format.

The Canadian Postal Code SHOULD be a six-character uniformly structured uppercase alphanumeric code in the form of "ANA NAN", where "A" represents an alphabetic character and "N" represents a numeric character, with one space between the first three and the last three characters.

A hyphen SHOULD NOT be used (example of UNacceptable format: T0L-1K0).

Preferred

The Practitioner.address MAY have a Preferred extension. This is the FHIR standard defined extension used as a flag denoting whether parent address item is preferred.

Qualifications & Credentials

In Canadian context qualifications and credentials are not synonymous. This difference is defined by slices applied to Practitioner.qualification.code.coding element.

Qualification defines a code for the degree or educational rank that the credential specifies and may also apply to an expertise type. This profile recommends to use Canadian QualifiedRoleType value set as the coded representation of the provider's qualification.

Credential defines a role type that is used to categorize an entity that delivers health care in an expected and professional manner to an entity in need of health care services. It uses Canadian HealthcareProviderRoleType value set as the coded representation of the provider's credentials.

The binding strength for the Practitioner.qualification.code element is Preferred meaning that implementers are encouraged to draw codes from the specified code system for interoperability purposes but are not required to do so to be considered conformant.

Example:

"code": {
  "coding": [
    {
      "system": "https://fhir.infoway-inforoute.ca/CodeSystem/scpqual",
      "code": "BSC",
      "display": "Bachelor of Science Degree"
    }
  ],
  "text": "Bachelor of Science Degree"
}