SPL Mapping FHIR R5 Implementation Guide
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SPL Mapping FHIR R5 Implementation Guide, published by HL7 International / Biomedical Research and Regulation. This guide is not an authorized publication; it is the continuous build for version 0.2.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-spl/ and changes regularly. See the Directory of published versions

Resource Profile: EstablishmentAffiliation - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the EstablishmentAffiliation resource profile.

Guidance on how to interpret the contents of this table can be found here

0. OrganizationAffiliation
2. OrganizationAffiliation.organization
Control1..?
TypeReference(EstablishmentRegistrantOrganization)
Must Supporttrue
4. OrganizationAffiliation.participatingOrganization
Control1..?
TypeReference(EstablishmentOrganization)
Must Supporttrue
6. OrganizationAffiliation.code
Control1..1
Must Supporttrue
Pattern Value{
  "coding" : [{
    "system" : "http://hl7.org/fhir/us/spl/CodeSystem/codesystem-organizationAffiliationCodes",
    "code" : "ESTABLISHMENT"
  }]
}

Guidance on how to interpret the contents of this table can be found here

0. OrganizationAffiliation
Definition

Defines an affiliation/association/relationship between 2 distinct organizations, that is not a part-of relationship/sub-division relationship.

ShortDefines an affiliation/association/relationship between 2 distinct organizations, that is not a part-of relationship/sub-division relationship
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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. OrganizationAffiliation.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.

ShortA set of rules under which this content was created
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 its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. OrganizationAffiliation.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline 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.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. OrganizationAffiliation.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 managable, 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).

ShortExtensions that cannot be ignored
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summarytrue
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 Namesextensions, user content
Invariantsele-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())
8. OrganizationAffiliation.organization
Definition

Organization where the role is available (primary organization/has members).

ShortOrganization where the role is available
Comments

For example, a Spotless Cleaning Services (participatingOrganization) is a supplier (code) to General Hospital (organization). Similarly, General Hospital (participatingOrganization) is a member (code) of Eastern HIE (organization). If there are two organizations that do not have a directional relationship, there would normally be a third organization that represents the joint partnership, and the two organizations would have a relationship to that joint Organization via two OrganizationAffiliations.

Control10..1
TypeReference(EstablishmentRegistrantOrganization, Organization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. OrganizationAffiliation.participatingOrganization
Definition

The Participating Organization provides/performs the role(s) defined by the code to the Primary Organization (e.g. providing services or is a member of).

ShortOrganization that provides/performs the role (e.g. providing services or is a member of)
Comments

See comments for OrganizationAffiliation.organization above.

Control10..1
TypeReference(EstablishmentOrganization, Organization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. OrganizationAffiliation.code
Definition

Definition of the role the participatingOrganization plays in the association.

ShortDefinition of the role the participatingOrganization plays
Control10..1*
BindingFor example codes, see OrganizationAffiliationRolehttp://hl7.org/fhir/ValueSet/organization-role
(example to http://hl7.org/fhir/ValueSet/organization-role)

The role the participating organization providing services to the primary organization.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Pattern Value{
  "coding" : [{
    "system" : "http://hl7.org/fhir/us/spl/CodeSystem/codesystem-organizationAffiliationCodes",
    "code" : "ESTABLISHMENT"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. OrganizationAffiliation
Definition

Defines an affiliation/association/relationship between 2 distinct organizations, that is not a part-of relationship/sub-division relationship.

ShortDefines an affiliation/association/relationship between 2 distinct organizations, that is not a part-of relationship/sub-division relationship
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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. OrganizationAffiliation.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

Control0..1
Typeid
Is Modifierfalse
Must Supportfalse
Summarytrue
4. OrganizationAffiliation.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.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. OrganizationAffiliation.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.

ShortA set of rules under which this content was created
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 its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. OrganizationAffiliation.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
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).

Control0..1
BindingThe codes SHALL be taken from AllLanguages
(required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

IETF language tag for a human language

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. OrganizationAffiliation.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.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have a 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.

Control0..1
This element is affected by the following invariants: dom-6
TypeNarrative
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. OrganizationAffiliation.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline 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.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. OrganizationAffiliation.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, 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.

ShortAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-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())
16. OrganizationAffiliation.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 managable, 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).

ShortExtensions that cannot be ignored
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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summarytrue
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 Namesextensions, user content
Invariantsele-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())
18. OrganizationAffiliation.identifier
Definition

Business identifiers that are specific to this role.

ShortBusiness identifiers that are specific to this role
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Often, specific identities are assigned for the agent.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. OrganizationAffiliation.active
Definition

Whether this organization affiliation record is in active use.

ShortWhether this organization affiliation record is in active use
Comments

If this value is false, you may refer to the period to see when the role was in active use. If there is no period specified, no inference can be made about when it was active.

Control0..1
Typeboolean
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Requirements

Need to be able to mark an organization affiliation record as not to be used because it was created in error, or otherwise no longer in active use.

Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. OrganizationAffiliation.period
Definition

The period during which the participatingOrganization is affiliated with the primary organization.

ShortThe period during which the participatingOrganization is affiliated with the primary organization
Control0..1
TypePeriod
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

An affiliation may be created ahead of time and only be active for a defined period of time. Once the affiliation is complete, the fact that it existed may still be required.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. OrganizationAffiliation.organization
Definition

Organization where the role is available (primary organization/has members).

ShortOrganization where the role is available
Comments

For example, a Spotless Cleaning Services (participatingOrganization) is a supplier (code) to General Hospital (organization). Similarly, General Hospital (participatingOrganization) is a member (code) of Eastern HIE (organization). If there are two organizations that do not have a directional relationship, there would normally be a third organization that represents the joint partnership, and the two organizations would have a relationship to that joint Organization via two OrganizationAffiliations.

Control1..1
TypeReference(EstablishmentRegistrantOrganization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. OrganizationAffiliation.participatingOrganization
Definition

The Participating Organization provides/performs the role(s) defined by the code to the Primary Organization (e.g. providing services or is a member of).

ShortOrganization that provides/performs the role (e.g. providing services or is a member of)
Comments

See comments for OrganizationAffiliation.organization above.

Control1..1
TypeReference(EstablishmentOrganization)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. OrganizationAffiliation.network
Definition

The network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined).

ShortThe network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
Comments

e.g. Commonly used for Health Insurance provider networks.

Control0..*
TypeReference(Organization)
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. OrganizationAffiliation.code
Definition

Definition of the role the participatingOrganization plays in the association.

ShortDefinition of the role the participatingOrganization plays
Control1..1
BindingFor example codes, see OrganizationAffiliationRole
(example to http://hl7.org/fhir/ValueSet/organization-role)

The role the participating organization providing services to the primary organization.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Pattern Value{
  "coding" : [{
    "system" : "http://hl7.org/fhir/us/spl/CodeSystem/codesystem-organizationAffiliationCodes",
    "code" : "ESTABLISHMENT"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. OrganizationAffiliation.specialty
Definition

Specific specialty of the participatingOrganization in the context of the role.

ShortSpecific specialty of the participatingOrganization in the context of the role
Control0..*
BindingThe codes SHOULD be taken from PracticeSettingCodeValueSet
(preferred to http://hl7.org/fhir/ValueSet/c80-practice-codes)

Specific specialty associated with the participating organization.

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. OrganizationAffiliation.location
Definition

The location(s) at which the role occurs.

ShortThe location(s) at which the role occurs
Control0..*
TypeReference(Location)
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. OrganizationAffiliation.healthcareService
Definition

Healthcare services provided through the role.

ShortHealthcare services provided through the role
Control0..*
TypeReference(HealthcareService)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. OrganizationAffiliation.contact
Definition

The contact details of communication devices available at the participatingOrganization relevant to this Affiliation.

ShortOfficial contact details at the participatingOrganization relevant to this Affiliation
Control0..*
TypeExtendedContactDetail
Is Modifierfalse
Must Supportfalse
Summaryfalse
Requirements

Sometimes a participating organization provides dedicated contacts to handle enquiries specifically for the role provided to the affiliated organization.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
org-3: The telecom of an organization can never be of use 'home' (telecom.where(use = 'home').empty())
org-4: The address of an organization can never be of use 'home' (address.where(use = 'home').empty())
40. OrganizationAffiliation.endpoint
Definition

Technical endpoints providing access to services operated for this role.

ShortTechnical endpoints providing access to services operated for this role
Control0..*
TypeReference(Endpoint)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))