QI-Core Implementation Guide
7.0.2 - STU 7

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 7.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

## Resource Profile: QICore Communication Not Done

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communicationnotdone | Version: 7.0.2
Standards status: Trial-use | Maturity Level: 4 | Computable Name: QICoreCommunicationNotDone

Negation profile of Communication for decision support/quality metrics. Indicates that the communication was not performed for a reason.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
QI Elements:

- extension(event-recorded): (QI) Captures the recorded date of the communication
- topic.extension(codeOptions): (QI) Url of a value set of candidate topics
- statusReason: (QI) Reason for current status
- sender: (QI) Message sender
- sent: (QI) When sent
- topic: (QI) Description of the purpose/content
- subject: (QI) Focus of message
- received: (QI) When received
- status: (QI) not-done
- recipient: (QI) Message recipient

Primary code path: topic
(PCPath) This element is the primary code path for this resource CQL Retrieve
Usage

The Communication profile defines the conformance expectations for a Communication event, regardless of whether it is a positive or negative statement.

The CommunicationDone and CommunicationNotDone profiles represent the positive and negative statements for a communication event.

This example meets measure intent for exclusion as defined in the following example CQL:

    define "Medication Not Available":
    ["CommunicationNotDone": "progress update"] ProgressUpdate
        where ProgressUpdate.topic = 'progress-update'
        and ProgressUpdate.status = 'completed'
        and ProgressUpdate.reasonCode = 'Medication not available from manufacturer (finding)'
            )

For a more complete discussion of representation of negation within QI-Core and quality improvement artifacts, see the Negation in QI-Core topic.

See the patterns page for implementation and usage patterns.

### Examples

Negation Example using a single coded concept | Communication of finding of Macular Edema absent not done because patient moved away.

Usages:

- Examples for this Profile: Communication/negation-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Communication | C | 0..* | QICoreCommunication | A record of information transmitted from a sender to a receiver Constraints: com-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:event-recorded |  | 1..1 | dateTime | (QI) Captures the recorded date of the communication URL: http://hl7.org/fhir/StructureDefinition/event-recorded
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (QI) not-done Binding: EventStatus (required): The status of the communication. Fixed Value: not-done
statusReason | Σ | 1..1 | CodeableConcept | (QI) Reason for current status Binding: QICore Negation Reason Codes (extensible)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Communication.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Communication.statusReason | Base | extensible | QICore Negation Reason Codes | 📦7.0.2 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
com-1 | error | Communication | to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided | `topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())`
dom-2 | error | Communication | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Communication | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Communication | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from QICoreCommunication

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Communication |  | 0..* | QICoreCommunication | A record of information transmitted from a sender to a receiver
Slices for extension |  |  |  | Content/Rules for all slices
extension:event-recorded |  | 1..1 | dateTime | (QI) Captures the recorded date of the communication URL: http://hl7.org/fhir/StructureDefinition/event-recorded
status |  | 1..1 | code | (QI) not-done Fixed Value: not-done
statusReason |  | 1..1 | CodeableConcept | (QI) Reason for current status Binding: QICore Negation Reason Codes (extensible)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Communication.statusReason | Base | extensible | QICore Negation Reason Codes | 📦7.0.2 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Communication | C | 0..* | QICoreCommunication | A record of information transmitted from a sender to a receiver Constraints: com-1
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
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:event-recorded |  | 1..1 | dateTime | (QI) Captures the recorded date of the communication URL: http://hl7.org/fhir/StructureDefinition/event-recorded
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Unique identifier
instantiatesCanonical | Σ | 0..* | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(Resource) | Request fulfilled by this communication
partOf | Σ | 0..* | Reference(Resource) | Part of this action
inResponseTo |  | 0..* | Reference(Communication) | Reply to
status | ?!Σ | 1..1 | code | (QI) not-done Binding: EventStatus (required): The status of the communication. Fixed Value: not-done
statusReason | Σ | 1..1 | CodeableConcept | (QI) Reason for current status Binding: QICore Negation Reason Codes (extensible)
category |  | 0..* | CodeableConcept | Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication.
medium |  | 0..* | CodeableConcept | A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject | Σ | 0..1 | Reference(QICore Patient | Group) | (QI) Focus of message
topic | C | 0..1 | CodeableConcept | (QI) Description of the purpose/content Binding: CommunicationTopic (1.0.0) (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:codeOptions | C | 0..1 | canonical(ValueSet) | (QI) Url of a value set of candidate topics URL: http://hl7.org/fhir/StructureDefinition/codeOptions
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
about |  | 0..* | Reference(Resource) | Resources that pertain to this communication
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
sent |  | 0..1 | dateTime | (QI) When sent
received |  | 0..1 | dateTime | (QI) When received
recipient |  | 0..* | Reference(QICore CareTeam | QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson | Group) | (QI) Message recipient
sender |  | 0..1 | Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson) | (QI) Message sender
reasonCode | Σ | 0..* | CodeableConcept | Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Why was communication done?
payload |  | 0..* | BackboneElement | Message payload
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
content[x] |  | 1..1 |  | Message part content
contentString |  |  | string |
contentAttachment |  |  | Attachment |
contentReference |  |  | Reference(Resource) |
note |  | 0..* | Annotation | Comments made about the communication
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Communication.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Communication.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Communication.statusReason | Base | extensible | QICore Negation Reason Codes | 📦7.0.2 | This IG
Communication.category | Base | example | CommunicationCategory | 📍4.0.1 | FHIR Std.
Communication.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
Communication.medium | Base | example | ParticipationMode | 📦3.0.0 | THO v6.5
Communication.topic | Base | preferred | CommunicationTopic | 📍1.0.0 | THO v5.5
Communication.reasonCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
com-1 | error | Communication | to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided | `topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())`
dom-2 | error | Communication | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Communication | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Communication | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from QICoreCommunication

Summary

Mandatory: 3 elements
Fixed: 1 element

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/event-recorded

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Communication | C | 0..* | QICoreCommunication | A record of information transmitted from a sender to a receiver Constraints: com-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:event-recorded |  | 1..1 | dateTime | (QI) Captures the recorded date of the communication URL: http://hl7.org/fhir/StructureDefinition/event-recorded
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | (QI) not-done Binding: EventStatus (required): The status of the communication. Fixed Value: not-done
statusReason | Σ | 1..1 | CodeableConcept | (QI) Reason for current status Binding: QICore Negation Reason Codes (extensible)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Communication.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Communication.statusReason | Base | extensible | QICore Negation Reason Codes | 📦7.0.2 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
com-1 | error | Communication | to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided | `topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())`
dom-2 | error | Communication | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Communication | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Communication | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from QICoreCommunication

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Communication |  | 0..* | QICoreCommunication | A record of information transmitted from a sender to a receiver
Slices for extension |  |  |  | Content/Rules for all slices
extension:event-recorded |  | 1..1 | dateTime | (QI) Captures the recorded date of the communication URL: http://hl7.org/fhir/StructureDefinition/event-recorded
status |  | 1..1 | code | (QI) not-done Fixed Value: not-done
statusReason |  | 1..1 | CodeableConcept | (QI) Reason for current status Binding: QICore Negation Reason Codes (extensible)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Communication.statusReason | Base | extensible | QICore Negation Reason Codes | 📦7.0.2 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Communication | C | 0..* | QICoreCommunication | A record of information transmitted from a sender to a receiver Constraints: com-1
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
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:event-recorded |  | 1..1 | dateTime | (QI) Captures the recorded date of the communication URL: http://hl7.org/fhir/StructureDefinition/event-recorded
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Unique identifier
instantiatesCanonical | Σ | 0..* | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(Resource) | Request fulfilled by this communication
partOf | Σ | 0..* | Reference(Resource) | Part of this action
inResponseTo |  | 0..* | Reference(Communication) | Reply to
status | ?!Σ | 1..1 | code | (QI) not-done Binding: EventStatus (required): The status of the communication. Fixed Value: not-done
statusReason | Σ | 1..1 | CodeableConcept | (QI) Reason for current status Binding: QICore Negation Reason Codes (extensible)
category |  | 0..* | CodeableConcept | Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication.
medium |  | 0..* | CodeableConcept | A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject | Σ | 0..1 | Reference(QICore Patient | Group) | (QI) Focus of message
topic | C | 0..1 | CodeableConcept | (QI) Description of the purpose/content Binding: CommunicationTopic (1.0.0) (preferred)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:codeOptions | C | 0..1 | canonical(ValueSet) | (QI) Url of a value set of candidate topics URL: http://hl7.org/fhir/StructureDefinition/codeOptions
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
about |  | 0..* | Reference(Resource) | Resources that pertain to this communication
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
sent |  | 0..1 | dateTime | (QI) When sent
received |  | 0..1 | dateTime | (QI) When received
recipient |  | 0..* | Reference(QICore CareTeam | QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson | Group) | (QI) Message recipient
sender |  | 0..1 | Reference(QICore Device | US Core Implantable Device Profile | QICore Organization | QICore Patient | QICore Practitioner | QICore RelatedPerson) | (QI) Message sender
reasonCode | Σ | 0..* | CodeableConcept | Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Why was communication done?
payload |  | 0..* | BackboneElement | Message payload
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
content[x] |  | 1..1 |  | Message part content
contentString |  |  | string |
contentAttachment |  |  | Attachment |
contentReference |  |  | Reference(Resource) |
note |  | 0..* | Annotation | Comments made about the communication
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Communication.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Communication.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Communication.statusReason | Base | extensible | QICore Negation Reason Codes | 📦7.0.2 | This IG
Communication.category | Base | example | CommunicationCategory | 📍4.0.1 | FHIR Std.
Communication.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
Communication.medium | Base | example | ParticipationMode | 📦3.0.0 | THO v6.5
Communication.topic | Base | preferred | CommunicationTopic | 📍1.0.0 | THO v5.5
Communication.reasonCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
com-1 | error | Communication | to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided | `topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())`
dom-2 | error | Communication | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Communication | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Communication | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Communication | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from QICoreCommunication

Summary

Mandatory: 3 elements
Fixed: 1 element

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/event-recorded

Maturity: 4

Other representations of profile: CSV, Excel, Schematron