PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0-ballot - STU 2 – Ballot

PACIO Advance Healthcare Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/pacio-adi/ and changes regularly. See the Directory of published versions

## Resource Profile: ADI Healthcare Agent Consent Permit

Official URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-ADIConsentPermit | Version: 2.0.0-ballot
Standards status: Trial-use | Maturity Level: 2 | Computable Name: ADIConsentPermit

This profile is used to represent permit consents for an advance directive participant such as a healthcare agent or advisor and power or limitation granted to such persons.

Usages:

- Examples for this Profile: Consent/Example-Smith-Johnson-HealthcareAgentConsent-Permit, Consent/Example-Smith-Johnson-HealthcareAgentConsent and Consent/Example-Smith-Johnson-HealthcareAgentConsent2

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
--- | --- | --- | --- | ---
Consent | C | 0..* | ADIHealthcareAgentConsent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5, HCA-consent-category, HCA-provision-purpose
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
text | S | 1..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
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent. Required Pattern: active
scope | ?!Σ | 1..1 | CodeableConcept | Which of the four areas this resource covers (extensible) Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81377-4
display |  | 1..1 | string | Representation defined by the system Fixed Value: Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category | S Σ | 1..1 | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version |  | 1..1 | string | Version of the system - if relevant Fixed Value: 1.0.0
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acd
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
patient | S Σ | 1..1 | Reference(US Core Patient Profile) | Who the consent applies to
dateTime | S Σ | 0..1 | dateTime | When this Consent was created or indexed
policy | S | 0..* | BackboneElement | Policies covered by this consent
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
provision | S Σ | 1..1 | BackboneElement | Constraints to the base Consent.policyRule
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 1..1 | code | deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent. Required Pattern: permit
actor | S | 1..* | BackboneElement | Who|what controlled by this rule (or group, by role)
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
role |  | 1..1 | CodeableConcept | How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference |  | 1..1 | Reference(ADI Healthcare Agent Participant) | Resource for the actor (or group, by role)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Consent.status | required | Pattern Value: active `http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1` From the FHIR Standard
Consent.scope | extensible | Pattern Value: LOINC Code 81377-4("Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported") `http://hl7.org/fhir/ValueSet/consent-scope` From the FHIR Standard
Consent.category | extensible | Pattern Value: acd `http://hl7.org/fhir/ValueSet/consent-category` From the FHIR Standard
Consent.provision.type | required | Pattern Value: permit `http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1` From the FHIR Standard
Consent.provision.actor.role | required | HealthcareAgentOrProxyChoices `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35` From https://vsac.nlm.nih.gov

#### Constraints

Id | Grade | Path(s) | Details | Requirements
HCA-consent-category | error | Consent | Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists() |
HCA-provision-purpose | error | Consent | Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists() |
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Consent | 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 | Consent | 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 | Consent | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Consent | 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() |
ppc-1 | error | Consent | Either a Policy or PolicyRule : policy.exists() or policyRule.exists() |
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not() |
ppc-3 | error | Consent | IF Scope=research, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='research').exists().not() |
ppc-4 | error | Consent | IF Scope=adr, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='adr').exists().not() |
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not() |

This structure is derived from ADIHealthcareAgentConsent

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent |  | 0..* | ADIHealthcareAgentConsent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
provision |  |  |  |
type |  | 1..1 | code | deny | permit Required Pattern: permit
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | ADIHealthcareAgentConsent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5, HCA-consent-category, HCA-provision-purpose
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 | S | 1..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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Identifier for this record (external references) Example General: {"system":"http://acme.org/identifier/local/eCMS","value":"Local eCMS identifier"}
status | ?!S Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent. Required Pattern: active
scope | ?!Σ | 1..1 | CodeableConcept | Which of the four areas this resource covers (extensible) Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81377-4
display |  | 1..1 | string | Representation defined by the system Fixed Value: Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category | S Σ | 1..1 | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version |  | 1..1 | string | Version of the system - if relevant Fixed Value: 1.0.0
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acd
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
patient | S Σ | 1..1 | Reference(US Core Patient Profile) | Who the consent applies to
dateTime | S Σ | 0..1 | dateTime | When this Consent was created or indexed
performer | Σ | 0..* | Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) | Who is agreeing to the policy and rules
organization | Σ | 0..* | Reference(Organization) | Custodian of the consent
source[x] | Σ | 0..1 |  | Source from which this consent is taken
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
policy | S | 0..* | BackboneElement | Policies covered by this consent
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
authority | C | 0..1 | uri | Enforcement source for policy
uri | C | 0..1 | uri | Specific policy covered by this consent
policyRule | Σ C | 0..1 | CodeableConcept | Regulation that this consents to Binding: ConsentPolicyRuleCodes (extensible): Regulatory policy examples.
verification | Σ | 0..* | BackboneElement | Consent Verified by patient or family
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
verified | Σ | 1..1 | boolean | Has been verified
verifiedWith |  | 0..1 | Reference(Patient | RelatedPerson) | Person who verified
verificationDate |  | 0..1 | dateTime | When consent verified
provision | S Σ | 1..1 | BackboneElement | Constraints to the base Consent.policyRule
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 1..1 | code | deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent. Required Pattern: permit
period | Σ | 0..1 | Period | Timeframe for this rule
actor | S | 1..* | BackboneElement | Who|what controlled by this rule (or group, by role)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
role |  | 1..1 | CodeableConcept | How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference |  | 1..1 | Reference(ADI Healthcare Agent Participant) | Resource for the actor (or group, by role)
action | Σ | 0..* | CodeableConcept | Actions controlled by this rule Binding: Healthcare Agent Decisions (extensible)
securityLabel | Σ | 0..* | Coding | Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose | Σ | 0..* | Coding | Context of activities covered by this rule Binding: v3 Code System ActReason (required)
class | Σ | 0..* | Coding | e.g. Resource Type, Profile, CDA, etc. Binding: ConsentContentClass (extensible): The class (type) of information a consent rule covers.
code | Σ | 0..* | CodeableConcept | e.g. LOINC or SNOMED CT code, etc. in the content Binding: ConsentContentCodes (example): If this code is found in an instance, then the exception applies.
dataPeriod | Σ | 0..1 | Period | Timeframe for data controlled by this rule
data | Σ | 0..* | BackboneElement | Data controlled by this rule
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
meaning | Σ | 1..1 | code | instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions.
reference | Σ | 1..1 | Reference(Resource) | The actual data reference
provision |  | 0..* | See provision (Consent) | Nested Exception Rules
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Consent.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Consent.status | required | Pattern Value: active `http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1` From the FHIR Standard
Consent.scope | extensible | Pattern Value: LOINC Code 81377-4("Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported") `http://hl7.org/fhir/ValueSet/consent-scope` From the FHIR Standard
Consent.category | extensible | Pattern Value: acd `http://hl7.org/fhir/ValueSet/consent-category` From the FHIR Standard
Consent.policyRule | extensible | ConsentPolicyRuleCodes `http://hl7.org/fhir/ValueSet/consent-policy` From the FHIR Standard
Consent.provision.type | required | Pattern Value: permit `http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1` From the FHIR Standard
Consent.provision.actor.role | required | HealthcareAgentOrProxyChoices `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35` From https://vsac.nlm.nih.gov
Consent.provision.action | extensible | ADIHCADecisionsVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADIHCADecisionsVS` From this IG
Consent.provision.securityLabel | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels` From the FHIR Standard
Consent.provision.purpose | required | ActReason `http://terminology.hl7.org/ValueSet/v3-ActReason`
Consent.provision.class | extensible | ConsentContentClass `http://hl7.org/fhir/ValueSet/consent-content-class` From the FHIR Standard
Consent.provision.code | example | ConsentContentCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/consent-content-code` From the FHIR Standard
Consent.provision.data.meaning | required | ConsentDataMeaning `http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
HCA-consent-category | error | Consent | Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists() |
HCA-provision-purpose | error | Consent | Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists() |
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Consent | 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 | Consent | 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 | Consent | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Consent | 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() |
ppc-1 | error | Consent | Either a Policy or PolicyRule : policy.exists() or policyRule.exists() |
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not() |
ppc-3 | error | Consent | IF Scope=research, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='research').exists().not() |
ppc-4 | error | Consent | IF Scope=adr, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='adr').exists().not() |
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not() |

This structure is derived from ADIHealthcareAgentConsent

Summary

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | ADIHealthcareAgentConsent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5, HCA-consent-category, HCA-provision-purpose
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
text | S | 1..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
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent. Required Pattern: active
scope | ?!Σ | 1..1 | CodeableConcept | Which of the four areas this resource covers (extensible) Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81377-4
display |  | 1..1 | string | Representation defined by the system Fixed Value: Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category | S Σ | 1..1 | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version |  | 1..1 | string | Version of the system - if relevant Fixed Value: 1.0.0
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acd
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
patient | S Σ | 1..1 | Reference(US Core Patient Profile) | Who the consent applies to
dateTime | S Σ | 0..1 | dateTime | When this Consent was created or indexed
policy | S | 0..* | BackboneElement | Policies covered by this consent
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
provision | S Σ | 1..1 | BackboneElement | Constraints to the base Consent.policyRule
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 1..1 | code | deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent. Required Pattern: permit
actor | S | 1..* | BackboneElement | Who|what controlled by this rule (or group, by role)
Slices for extension |  |  |  | Content/Rules for all slices
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
role |  | 1..1 | CodeableConcept | How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference |  | 1..1 | Reference(ADI Healthcare Agent Participant) | Resource for the actor (or group, by role)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Consent.status | required | Pattern Value: active `http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1` From the FHIR Standard
Consent.scope | extensible | Pattern Value: LOINC Code 81377-4("Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported") `http://hl7.org/fhir/ValueSet/consent-scope` From the FHIR Standard
Consent.category | extensible | Pattern Value: acd `http://hl7.org/fhir/ValueSet/consent-category` From the FHIR Standard
Consent.provision.type | required | Pattern Value: permit `http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1` From the FHIR Standard
Consent.provision.actor.role | required | HealthcareAgentOrProxyChoices `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35` From https://vsac.nlm.nih.gov

#### Constraints

Id | Grade | Path(s) | Details | Requirements
HCA-consent-category | error | Consent | Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists() |
HCA-provision-purpose | error | Consent | Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists() |
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Consent | 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 | Consent | 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 | Consent | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Consent | 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() |
ppc-1 | error | Consent | Either a Policy or PolicyRule : policy.exists() or policyRule.exists() |
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not() |
ppc-3 | error | Consent | IF Scope=research, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='research').exists().not() |
ppc-4 | error | Consent | IF Scope=adr, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='adr').exists().not() |
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not() |

Differential View

This structure is derived from ADIHealthcareAgentConsent

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent |  | 0..* | ADIHealthcareAgentConsent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
provision |  |  |  |
type |  | 1..1 | code | deny | permit Required Pattern: permit
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | ADIHealthcareAgentConsent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5, HCA-consent-category, HCA-provision-purpose
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 | S | 1..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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Identifier for this record (external references) Example General: {"system":"http://acme.org/identifier/local/eCMS","value":"Local eCMS identifier"}
status | ?!S Σ | 1..1 | code | draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent. Required Pattern: active
scope | ?!Σ | 1..1 | CodeableConcept | Which of the four areas this resource covers (extensible) Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 81377-4
display |  | 1..1 | string | Representation defined by the system Fixed Value: Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category | S Σ | 1..1 | CodeableConcept | Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version |  | 1..1 | string | Version of the system - if relevant Fixed Value: 1.0.0
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: acd
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
patient | S Σ | 1..1 | Reference(US Core Patient Profile) | Who the consent applies to
dateTime | S Σ | 0..1 | dateTime | When this Consent was created or indexed
performer | Σ | 0..* | Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole) | Who is agreeing to the policy and rules
organization | Σ | 0..* | Reference(Organization) | Custodian of the consent
source[x] | Σ | 0..1 |  | Source from which this consent is taken
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
policy | S | 0..* | BackboneElement | Policies covered by this consent
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
authority | C | 0..1 | uri | Enforcement source for policy
uri | C | 0..1 | uri | Specific policy covered by this consent
policyRule | Σ C | 0..1 | CodeableConcept | Regulation that this consents to Binding: ConsentPolicyRuleCodes (extensible): Regulatory policy examples.
verification | Σ | 0..* | BackboneElement | Consent Verified by patient or family
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
verified | Σ | 1..1 | boolean | Has been verified
verifiedWith |  | 0..1 | Reference(Patient | RelatedPerson) | Person who verified
verificationDate |  | 0..1 | dateTime | When consent verified
provision | S Σ | 1..1 | BackboneElement | Constraints to the base Consent.policyRule
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 1..1 | code | deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent. Required Pattern: permit
period | Σ | 0..1 | Period | Timeframe for this rule
actor | S | 1..* | BackboneElement | Who|what controlled by this rule (or group, by role)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:ClauseExtension |  | 0..* | (Complex) | Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
role |  | 1..1 | CodeableConcept | How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference |  | 1..1 | Reference(ADI Healthcare Agent Participant) | Resource for the actor (or group, by role)
action | Σ | 0..* | CodeableConcept | Actions controlled by this rule Binding: Healthcare Agent Decisions (extensible)
securityLabel | Σ | 0..* | Coding | Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose | Σ | 0..* | Coding | Context of activities covered by this rule Binding: v3 Code System ActReason (required)
class | Σ | 0..* | Coding | e.g. Resource Type, Profile, CDA, etc. Binding: ConsentContentClass (extensible): The class (type) of information a consent rule covers.
code | Σ | 0..* | CodeableConcept | e.g. LOINC or SNOMED CT code, etc. in the content Binding: ConsentContentCodes (example): If this code is found in an instance, then the exception applies.
dataPeriod | Σ | 0..1 | Period | Timeframe for data controlled by this rule
data | Σ | 0..* | BackboneElement | Data controlled by this rule
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
meaning | Σ | 1..1 | code | instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions.
reference | Σ | 1..1 | Reference(Resource) | The actual data reference
provision |  | 0..* | See provision (Consent) | Nested Exception Rules
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Consent.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Consent.status | required | Pattern Value: active `http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1` From the FHIR Standard
Consent.scope | extensible | Pattern Value: LOINC Code 81377-4("Goals, preferences, and priorities regarding the appointment of healthcare agents Narrative - Reported") `http://hl7.org/fhir/ValueSet/consent-scope` From the FHIR Standard
Consent.category | extensible | Pattern Value: acd `http://hl7.org/fhir/ValueSet/consent-category` From the FHIR Standard
Consent.policyRule | extensible | ConsentPolicyRuleCodes `http://hl7.org/fhir/ValueSet/consent-policy` From the FHIR Standard
Consent.provision.type | required | Pattern Value: permit `http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1` From the FHIR Standard
Consent.provision.actor.role | required | HealthcareAgentOrProxyChoices `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35` From https://vsac.nlm.nih.gov
Consent.provision.action | extensible | ADIHCADecisionsVS `http://hl7.org/fhir/us/pacio-adi/ValueSet/ADIHCADecisionsVS` From this IG
Consent.provision.securityLabel | extensible | All Security Labels `http://hl7.org/fhir/ValueSet/security-labels` From the FHIR Standard
Consent.provision.purpose | required | ActReason `http://terminology.hl7.org/ValueSet/v3-ActReason`
Consent.provision.class | extensible | ConsentContentClass `http://hl7.org/fhir/ValueSet/consent-content-class` From the FHIR Standard
Consent.provision.code | example | ConsentContentCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/consent-content-code` From the FHIR Standard
Consent.provision.data.meaning | required | ConsentDataMeaning `http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
HCA-consent-category | error | Consent | Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists() |
HCA-provision-purpose | error | Consent | Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists() |
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Consent | 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 | Consent | 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 | Consent | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Consent | 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() |
ppc-1 | error | Consent | Either a Policy or PolicyRule : policy.exists() or policyRule.exists() |
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not() |
ppc-3 | error | Consent | IF Scope=research, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='research').exists().not() |
ppc-4 | error | Consent | IF Scope=adr, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='adr').exists().not() |
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not() |

This structure is derived from ADIHealthcareAgentConsent

Summary

Maturity: 2

Other representations of profile: CSV, Excel, Schematron