QI-Core Implementation Guide
4.1.0 - release

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## Resource Profile: QICoreCommunicationNotDone - Detailed Descriptions

Definitions for the qicore-communicationnotdone resource profile.

1. Communication
Definition | An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency that was notified about a reportable condition.
Control | 0..*
Invariants | Defined on this element cnd-1: to indicate what communication was not carried out, either at least one coding in the reasonCode or a notDoneValueSet extension shall be provided (: reasonCode.extension("http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet").exists() xor reasonCode.coding.exists()) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. Communication.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | string
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
3. Communication.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Control | 0..1
Type | Meta
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Communication.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Control | 0..1
Type | uri
Is Modifier | true
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Communication.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages Max Binding: AllLanguages A human language.
Type | code
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Communication.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Communication.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
8. Communication.extension
Definition | An Extension
Control | 0..*
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Communication.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
9. Communication.extension:recorded
SliceName | recorded
Definition | Captures the recorded date of the event.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(QICoreNotDoneRecorded) (Extension Type: dateTime)
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Communication.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. Communication.identifier
Definition | Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Requirements | Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.
Comments | This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Communication.instantiatesCanonical
Definition | The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.
Control | 0..*
Type | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Communication.instantiatesUri
Definition | The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.
Control | 0..*
Type | uri
Comments | This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Communication.basedOn
Definition | An order, proposal or plan fulfilled in whole or in part by this Communication.
Control | 0..*
Type | Reference(Resource)
Alternate Names | fulfills
Comments | This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Communication.partOf
Definition | Part of this action.
Control | 0..*
Type | Reference(Resource)
Alternate Names | container
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Communication.inResponseTo
Definition | Prior communication that this communication is in response to.
Control | 0..*
Type | Reference(Communication)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Communication.status
Definition | The status of the transmission.
Control | 1..1
Binding | The codes SHALL be taken from EventStatus The status of the communication.
Type | code
Is Modifier | true
Must Support | true
Comments | This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.
Fixed Value | not-done
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. Communication.statusReason
Definition | Captures the reason for the current state of the Communication.
Control | 1..1
Binding | The codes SHALL be taken from Negation Reason Codes; other codes may be used where these codes are not suitable
Type | CodeableConcept
Must Support | true
Alternate Names | Suspended Reason, Cancelled Reason
Comments | This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Communication.category
Definition | The type of message conveyed such as alert, notification, reminder, instruction, etc.
Control | 0..*
Binding | For example codes, see CommunicationCategory Codes for general categories of communications such as alerts, instructions, etc.
Type | CodeableConcept
Comments | There may be multiple axes of categorization and one communication may serve multiple purposes.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Communication.priority
Definition | Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.
Control | 0..1
Binding | The codes SHALL be taken from RequestPriority Codes indicating the relative importance of a communication.
Type | code
Comments | Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.
Meaning if Missing | If missing, this communication should be treated with normal priority
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Communication.medium
Definition | A channel that was used for this communication (e.g. email, fax).
Control | 0..*
Binding | For example codes, see ParticipationMode Codes for communication mediums such as phone, fax, email, in person, etc.
Type | CodeableConcept
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Communication.subject
Definition | The patient or group that was the focus of this communication.
Control | 0..1
Type | Reference(Patient | Group)
Alternate Names | patient
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Communication.topic
Definition | Description of the purpose/content, similar to a subject line in an email.
Control | 0..1
Binding | For example codes, see CommunicationTopic Codes describing the purpose or content of the communication.
Type | CodeableConcept
Comments | Communication.topic.text can be used without any codings.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Communication.about
Definition | Other resources that pertain to this communication and to which this communication should be associated.
Control | 0..*
Type | Reference(Resource)
Comments | Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Communication.encounter
Definition | The Encounter during which this Communication was created or to which the creation of this record is tightly associated.
Control | 0..1
Type | Reference(Encounter)
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Communication.sent
Definition | The time when this communication was sent.
Control | 0..1
Type | dateTime
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Communication.received
Definition | The time when this communication arrived at the destination.
Control | 0..1
Type | dateTime
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Communication.recipient
Definition | The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).
Control | 0..*
Type | Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Communication.sender
Definition | The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.
Control | 0..1
Type | Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Communication.reasonCode
Definition | The reason or justification for the communication.
Control | 1..1 This element is affected by the following invariants: cnd-1
Binding | For example codes, see SNOMEDCTClinicalFindings Codes for describing reasons for the occurrence of a communication.
Type | CodeableConcept
Must Support | true
Comments | Textual reasons can be captured using reasonCode.text.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Communication.reasonCode.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
32. Communication.reasonCode.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Communication.reasonCode.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
33. Communication.reasonCode.extension:notDoneValueSet
SliceName | notDoneValueSet
Definition | A logical reference (e.g. a reference to ValueSet.url) to a value set/version that identifies a set of possible coded values representing activities that were not requested, ordered, or performed.
Control | 0..1 This element is affected by the following invariants: cnd-1
Type | Extension(NotDoneValueSet) (Extension Type: canonical(ValueSet))
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
34. Communication.reasonCode.coding
Definition | A reference to a code defined by a terminology system.
Control | 0..*
Type | Coding
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Communication.reasonCode.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Control | 0..1
Type | string
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Comments | Very often the text is the same as a displayName of one of the codings.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Communication.reasonReference
Definition | Indicates another resource whose existence justifies this communication.
Control | 0..*
Type | Reference(Condition | Observation | DiagnosticReport | DocumentReference)
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Communication.payload
Definition | Text, attachment(s), or resource(s) that was communicated to the recipient.
Control | 0..*
Type | BackboneElement
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Communication.payload.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
39. Communication.payload.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
40. Communication.payload.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Control | 0..*
Type | Extension
Is Modifier | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
41. Communication.payload.content[x]
Definition | A communicated content (or for multi-part communications, one portion of the communication).
Control | 1..1
Type | Choice of: string, Attachment, Reference(Resource)
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. Communication.note
Definition | Additional notes or commentary about the communication by the sender, receiver or other interested parties.
Control | 0..*
Type | Annotation
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))