QI-Core Implementation Guide
4.1.0 - release

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## Resource Profile: QICoreCommunication

Defining URL: | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication
Version: | 4.1.0
Name: | QICoreCommunication
Status: | Draft as of 8/22/18
Definition: | Profile of Communication for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
Publisher: | http://www.hl7.org/Special/committees/cqi/index.cfm
Source Resource: | XML / JSON / Turtle

The official URL for this profile is:

    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-communication

Usage

See the patterns page for implementation and usage patterns.

To create an expression specifically requesting information that a communication intentionally did not occur for a medical, patient or system reason, use the profile QICore-communicationnotdone.

The Communication and CommunicationNotDone profiles represent the positive and negative statements for a communication event. To ensure instances retrieved meet positive intent, applications should check the status as illustrated in this example:

    define Communication:
      [Communication] C
        where C.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }

### Examples

Written Alert Example

### Formal Views of Profile Content

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

- Text Summary
- Differential Table
- Snapshot Table
- Snapshot Table (Must Support)
- All

This structure is derived from Communication

Summary

Must-Support: 11 elements

Structures

This structure refers to these other structures:

- QICorePatient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
- QICoreEncounter (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter)
- QICoreDevice (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device)
- QICoreOrganization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
- QICorePractitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
- QICoreRelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)

This structure is derived from Communication

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Communication |  | 0..* | Communication | A record of information transmitted from a sender to a receiver
status | S | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
statusReason | S | 0..1 | CodeableConcept | Reason for current status
category | S | 0..* | CodeableConcept | Message category
medium | S | 0..* | CodeableConcept | A channel of communication
subject | S | 0..1 | Reference(QICorePatient | Group) | Focus of message
encounter | S | 0..1 | Reference(QICoreEncounter) | Encounter created as part of
sent | S | 0..1 | dateTime | When sent
received | S | 0..1 | dateTime | When received
recipient | S | 0..* | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson | Group) | Message recipient
sender | S | 0..1 | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson) | Message sender
reasonCode | S | 0..* | CodeableConcept | Indication for message
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Communication |  | 0..* | Communication | A record of information transmitted from a sender to a receiver
id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language.
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
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 | ?!S Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
statusReason | S Σ | 0..1 | CodeableConcept | Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
category | S | 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 | S | 0..* | CodeableConcept | A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject | S Σ | 0..1 | Reference(QICorePatient | Group) | Focus of message
topic |  | 0..1 | CodeableConcept | Description of the purpose/content Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
about |  | 0..* | Reference(Resource) | Resources that pertain to this communication
encounter | S Σ | 0..1 | Reference(QICoreEncounter) | Encounter created as part of
sent | S | 0..1 | dateTime | When sent
received | S | 0..1 | dateTime | When received
recipient | S | 0..* | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson | Group) | Message recipient
sender | S | 0..1 | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson) | Message sender
reasonCode | S 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

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Communication |  | 0..* | Communication | A record of information transmitted from a sender to a receiver
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
statusReason | Σ | 0..1 | CodeableConcept | Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
category |  | 0..* | CodeableConcept | Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
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(QICorePatient | Group) | Focus of message
encounter | Σ | 0..1 | Reference(QICoreEncounter) | Encounter created as part of
sent |  | 0..1 | dateTime | When sent
received |  | 0..1 | dateTime | When received
recipient |  | 0..* | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson | Group) | Message recipient
sender |  | 0..1 | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson) | Message sender
reasonCode | Σ | 0..* | CodeableConcept | Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
Documentation for this format

This structure is derived from Communication

Summary

Must-Support: 11 elements

Structures

This structure refers to these other structures:

- QICorePatient (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient)
- QICoreEncounter (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter)
- QICoreDevice (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device)
- QICoreOrganization (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization)
- QICorePractitioner (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner)
- QICoreRelatedPerson (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson)

Differential View

This structure is derived from Communication

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Communication |  | 0..* | Communication | A record of information transmitted from a sender to a receiver
status | S | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
statusReason | S | 0..1 | CodeableConcept | Reason for current status
category | S | 0..* | CodeableConcept | Message category
medium | S | 0..* | CodeableConcept | A channel of communication
subject | S | 0..1 | Reference(QICorePatient | Group) | Focus of message
encounter | S | 0..1 | Reference(QICoreEncounter) | Encounter created as part of
sent | S | 0..1 | dateTime | When sent
received | S | 0..1 | dateTime | When received
recipient | S | 0..* | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson | Group) | Message recipient
sender | S | 0..1 | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson) | Message sender
reasonCode | S | 0..* | CodeableConcept | Indication for message
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Communication |  | 0..* | Communication | A record of information transmitted from a sender to a receiver
id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language.
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
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 | ?!S Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
statusReason | S Σ | 0..1 | CodeableConcept | Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
category | S | 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 | S | 0..* | CodeableConcept | A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject | S Σ | 0..1 | Reference(QICorePatient | Group) | Focus of message
topic |  | 0..1 | CodeableConcept | Description of the purpose/content Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
about |  | 0..* | Reference(Resource) | Resources that pertain to this communication
encounter | S Σ | 0..1 | Reference(QICoreEncounter) | Encounter created as part of
sent | S | 0..1 | dateTime | When sent
received | S | 0..1 | dateTime | When received
recipient | S | 0..* | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson | Group) | Message recipient
sender | S | 0..1 | Reference(QICoreDevice | QICoreOrganization | QICorePatient | QICorePractitioner | QICoreRelatedPerson) | Message sender
reasonCode | S 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

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Conformance | ValueSet
Communication.language | preferred | CommonLanguages Max Binding: AllLanguages
Communication.status | required | EventStatus
Communication.statusReason | example | CommunicationNotDoneReason
Communication.category | example | CommunicationCategory
Communication.priority | required | RequestPriority
Communication.medium | example | ParticipationMode
Communication.topic | example | CommunicationTopic
Communication.reasonCode | example | SNOMEDCTClinicalFindings

#### Constraints

Id | Grade | Path | Details | Requirements
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 | Communication.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Communication.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Communication.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Communication.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Communication.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.instantiatesCanonical | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.instantiatesUri | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.basedOn | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.partOf | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.inResponseTo | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.statusReason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.priority | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.medium | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.subject | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.topic | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.about | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.encounter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.sent | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.received | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.recipient | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.sender | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.reasonCode | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.reasonReference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.payload | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.payload.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Communication.payload.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Communication.payload.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | Communication.payload.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
ele-1 | error | Communication.payload.content[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | error | Communication.note | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |