New Zealand ICP Implementation Guide
1.0.0 - release

New Zealand ICP Implementation Guide, published by Accident Compensation Corporation. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/acc-fhir-publisher/icp/ and changes regularly. See the Directory of published versions

Resource Profile: IcpCaseModify - Detailed Descriptions

Active as of 2022-11-20

Definitions for the acc-icp-case-modify resource profile.

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

0. EpisodeOfCare
Invariantsactive-status-invariant: The status attribute must be set to 'active'. (status = 'active')
2. EpisodeOfCare.extension
Control2..3
SlicingThis element introduces a set of slices on EpisodeOfCare.extension. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
  • value @ url
  • 4. EpisodeOfCare.extension:service-bundle-change
    Slice Nameservice-bundle-change
    ShortThe updated ICP service bundle for the treatment.
    Control1..1
    TypeExtension(ICP Service Bundle Change) (Complex Extension)
    6. EpisodeOfCare.extension:exceptional-funding
    Slice Nameexceptional-funding
    ShortIndicates if exceptionalfunding is required for this treatment and the funding type.
    Control0..1
    TypeExtension(Exceptional Funding) (Complex Extension)
    8. EpisodeOfCare.status
    Definition

    The Status of the ICP case (must be Active).

    10. EpisodeOfCare.type
    Control0..0
    12. EpisodeOfCare.period
    Control0..0

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

    0. EpisodeOfCare
    Definition

    An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time.

    ShortAn association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Alternate NamesCase Program Problem
    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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    end-date-when-active-invariant: End date is not allowed when status is active (status = 'active' implies period.end.empty())
    end-date-when-finished-invariant: End date is required when status is finished (status = 'finished' implies period.end.exists())
    active-status-invariant: The status attribute must be set to 'active'. (status = 'active')
    2. EpisodeOfCare.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 it's 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 it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. EpisodeOfCare.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

    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.

    Control10..*
    TypeResource
    Is Modifierfalse
    Summaryfalse
    Alternate Namesinline resources, anonymous resources, contained resources
    SlicingThis element introduces a set of slices on EpisodeOfCare.contained. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 6. EpisodeOfCare.contained:patient
      Slice Namepatient
      Definition

      Contained patient resource for the required patient's date of birth.


      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortPatient's date of birth.Contained, 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.

      Control10..1*
      TypePatientResource(ACC ICP Patient)
      Is Modifierfalse
      Summaryfalse
      Alternate NamesSubjectOfCare Client Resident, inline resources, anonymous resources, contained resources
      8. EpisodeOfCare.extension
      Definition

      An Extension


      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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional 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.

      Control20..3*
      TypeExtension
      Is Modifierfalse
      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())
      SlicingThis element introduces a set of slices on EpisodeOfCare.extension. The slices areUnordered and ClosedOpen, and can be differentiated using the following discriminators:
      • value @ url
      • 10. EpisodeOfCare.extension:acc-providerid
        Slice Nameacc-providerid
        Definition

        This represents the person submitting this form to ACC. It should take the form of their ACC Provider ID.

        ShortThe ACC provider ID associated with the ICP case
        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(ACC Provider ID) (Extension Type: string)
        Is Modifierfalse
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. EpisodeOfCare.extension:service-bundle-change
        Slice Nameservice-bundle-change
        Definition

        An extension to capture the reason for a change in the ICP Service Bundle.

        ShortThe updated ICP service bundle for the treatment.
        Control1..1
        TypeExtension(ICP Service Bundle Change) (Complex Extension)
        Is Modifierfalse
        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())
        14. EpisodeOfCare.extension:exceptional-funding
        Slice Nameexceptional-funding
        Definition

        Indicates if exceptional is required for this treatment.

        ShortIndicates if exceptionalfunding is required for this treatment and the funding type.
        Control0..1
        TypeExtension(Exceptional Funding) (Complex Extension)
        Is Modifierfalse
        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. EpisodeOfCare.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        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
        Summaryfalse
        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. EpisodeOfCare.identifier
        Definition

        The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

        ShortBusiness Identifier(s) relevant for this EpisodeOfCare
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..1*
        TypeIdentifier
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on EpisodeOfCare.identifier. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • value @ system
        • 20. EpisodeOfCare.identifier:icpclaimnumber
          Slice Nameicpclaimnumber
          Definition

          The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

          ShortThe ACC 45 number to be used in combination with the contained patient's date of birth, as the ICP case idenfitier.Business Identifier(s) relevant for this EpisodeOfCare
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control10..1*
          TypeIdentifier
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. EpisodeOfCare.identifier:icpclaimnumber.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..01
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          24. EpisodeOfCare.identifier:icpclaimnumber.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortExtensionAdditional 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..0*
          TypeExtension
          Is Modifierfalse
          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())
          SlicingThis element introduces a set of slices on EpisodeOfCare.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 26. EpisodeOfCare.identifier:icpclaimnumber.use
            Definition

            The purpose of this identifier.

            Shortusual | official | temp | secondary | old (If known)
            Comments

            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

            Control0..1
            BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

            Identifies the purpose for this identifier, if known .

            Typecode
            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. EpisodeOfCare.identifier:icpclaimnumber.system
            Definition

            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

            ShortThe namespace for the identifier value
            Comments

            Identifier.system is always case sensitive.

            Control10..1
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

            Fixed Valuehttps://standards.digital.health.nz/ns/acc-45-number
            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. EpisodeOfCare.identifier:icpclaimnumber.value
            Definition

            The portion of the identifier typically relevant to the user and which is unique within the context of the system.

            ShortThe ACC 45 number.The value that is unique
            Comments

            If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

            Control10..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Example<br/><b>General</b>:123456
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            acc-claim-number: The claim number format is invalid; it must be in the form A999999, AA99999, 9999AAA or 99999AA, where A is any capital letter, 9 is any single digit, and there are 7 characters altogether. ($this.toString().matches('^[A-Z][0-9]{6}$|^[A-Z]{2}[0-9]{5}$|^[0-9]{4}[A-Z]{3}$|^[0-9]{5}[A-Z]{2}$'))
            32. EpisodeOfCare.identifier:icpclaimnumber.period
            Definition

            Time period during which identifier is/was valid for use.

            ShortTime period when id is/was valid for use
            Control0..01
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. EpisodeOfCare.identifier:icpclaimnumber.assigner
            Definition

            Organization that issued/manages the identifier.

            ShortOrganization that issued id (may be just text)
            Comments

            The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

            Control0..01
            TypeReference(Organization)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. EpisodeOfCare.status
            Definition

            The Status of the ICP case (must be Active).


            planned | waitlist | active | onhold | finished | cancelled.

            Shortactive | finishedplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
            Comments

            This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid.

            Control1..1
            BindingThe codes SHALL be taken from Statushttp://hl7.org/fhir/ValueSet/episode-of-care-status|4.0.1
            (required to http://hl7.org.nz/fhir/ValueSet/acc-icp-episodeofcare-status)
            Typecode
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. EpisodeOfCare.statusHistory
            Definition

            The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource).

            ShortPast list of status codes (the current status may be included to cover the start date of the status)
            Control0..0*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            43. EpisodeOfCare.type
            Definition

            A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care.

            ShortThe type of ICP service. Currently only musculoskeletal (msk) is allowed, with more to be added in the future, e.g. concussion.Type/class - e.g. specialist referral, disease management
            Comments

            The type can be very important in processing as this could be used in determining if the EpisodeOfCare is relevant to specific government reporting, or other types of classifications.

            Control0..0*
            BindingFor example codes, see EpisodeOfCareTypehttp://hl7.org/fhir/ValueSet/episodeofcare-type
            (example to http://hl7.org/fhir/ValueSet/episodeofcare-type)

            The type of the episode of care.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. EpisodeOfCare.diagnosis
            Definition

            The list of diagnosis relevant to this episode of care.

            ShortThe list of diagnosis relevant to this episode of care
            Control0..0*
            TypeBackboneElement
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. EpisodeOfCare.patient
            Definition

            The patient who is the focus of this episode of care.

            ShortThe patient who is the focus of this episode of care
            Control1..1
            TypeReference(ACC ICP Patient, Patient)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. EpisodeOfCare.managingOrganization
            Definition

            The organization that has assumed the specific responsibilities for the specified duration.

            ShortThis is the ACC Vendor ID, in most cases this is the organisation's HPI ID.Organization that assumes care
            Control10..1
            TypeReference(Organization)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. EpisodeOfCare.period
            Definition

            The interval during which the managing organization assumes the defined responsibility.

            ShortInterval during responsibility is assumed
            Control0..01
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. EpisodeOfCare.referralRequest
            Definition

            Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals.

            ShortOriginating Referral Request(s)
            Control0..0*
            TypeReference(ServiceRequest)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. EpisodeOfCare.careManager
            Definition

            The practitioner that is the care manager/care coordinator for this patient.

            ShortCare manager/care coordinator for the patient
            Control0..01
            TypeReference(Practitioner, PractitionerRole)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. EpisodeOfCare.team
            Definition

            The list of practitioners that may be facilitating this episode of care for specific purposes.

            ShortOther practitioners facilitating this episode of care
            Control0..0*
            TypeReference(CareTeam)
            Is Modifierfalse
            Summaryfalse
            Alternate NamesCareTeam
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. EpisodeOfCare.account
            Definition

            The set of accounts that may be used for billing for this EpisodeOfCare.

            ShortThe set of accounts that may be used for billing for this EpisodeOfCare
            Comments

            The billing system may choose to allocate billable items associated with the EpisodeOfCare to different referenced Accounts based on internal business rules.

            Control0..0*
            TypeReference(Account)
            Is Modifierfalse
            Summaryfalse
            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. EpisodeOfCare
            Definition

            An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time.

            ShortAn association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
            Control0..*
            Is Modifierfalse
            Summaryfalse
            Alternate NamesCase Program Problem
            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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
            dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
            dom-6: A resource should have narrative for robust management (text.`div`.exists())
            end-date-when-active-invariant: End date is not allowed when status is active (status = 'active' implies period.end.empty())
            end-date-when-finished-invariant: End date is required when status is finished (status = 'finished' implies period.end.exists())
            active-status-invariant: The status attribute must be set to 'active'. (status = 'active')
            2. EpisodeOfCare.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

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Is Modifierfalse
            Summarytrue
            4. EpisodeOfCare.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
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. EpisodeOfCare.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 it's 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 it's meaning or interpretation
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            8. EpisodeOfCare.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 SHOULD be taken from CommonLanguages
            (preferred to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            10. EpisodeOfCare.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 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
            TypeNarrative
            Is Modifierfalse
            Summaryfalse
            Alternate Namesnarrative, html, xhtml, display
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. EpisodeOfCare.contained
            Definition

            These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

            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.

            Control1..*
            TypeResource
            Is Modifierfalse
            Summaryfalse
            Alternate Namesinline resources, anonymous resources, contained resources
            SlicingThis element introduces a set of slices on EpisodeOfCare.contained. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 14. EpisodeOfCare.contained:patient
              Slice Namepatient
              Definition

              Contained patient resource for the required patient's date of birth.

              ShortPatient's date of birth.
              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.

              Control1..1
              TypePatient(ACC ICP Patient)
              Is Modifierfalse
              Summaryfalse
              Alternate NamesSubjectOfCare Client Resident
              16. EpisodeOfCare.extension
              Definition

              An Extension

              ShortExtension
              Control2..3
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              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())
              SlicingThis element introduces a set of slices on EpisodeOfCare.extension. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
              • value @ url
              • 18. EpisodeOfCare.extension:acc-providerid
                Slice Nameacc-providerid
                Definition

                This represents the person submitting this form to ACC. It should take the form of their ACC Provider ID.

                ShortThe ACC provider ID associated with the ICP case
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeExtension(ACC Provider ID) (Extension Type: string)
                Is Modifierfalse
                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())
                20. EpisodeOfCare.extension:service-bundle-change
                Slice Nameservice-bundle-change
                Definition

                An extension to capture the reason for a change in the ICP Service Bundle.

                ShortThe updated ICP service bundle for the treatment.
                Control1..1
                TypeExtension(ICP Service Bundle Change) (Complex Extension)
                Is Modifierfalse
                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())
                22. EpisodeOfCare.extension:exceptional-funding
                Slice Nameexceptional-funding
                Definition

                Indicates if exceptional is required for this treatment.

                ShortIndicates if exceptionalfunding is required for this treatment and the funding type.
                Control0..1
                TypeExtension(Exceptional Funding) (Complex Extension)
                Is Modifierfalse
                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())
                24. EpisodeOfCare.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                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
                Summaryfalse
                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())
                26. EpisodeOfCare.identifier
                Definition

                The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

                ShortBusiness Identifier(s) relevant for this EpisodeOfCare
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..1
                TypeIdentifier
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on EpisodeOfCare.identifier. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • value @ system
                • 28. EpisodeOfCare.identifier:icpclaimnumber
                  Slice Nameicpclaimnumber
                  Definition

                  The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

                  ShortThe ACC 45 number to be used in combination with the contained patient's date of birth, as the ICP case idenfitier.
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..1
                  TypeIdentifier
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  30. EpisodeOfCare.identifier:icpclaimnumber.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..0
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  32. EpisodeOfCare.identifier:icpclaimnumber.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..0
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  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())
                  SlicingThis element introduces a set of slices on EpisodeOfCare.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 34. EpisodeOfCare.identifier:icpclaimnumber.use
                    Definition

                    The purpose of this identifier.

                    Shortusual | official | temp | secondary | old (If known)
                    Comments

                    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                    Control0..1
                    BindingThe codes SHALL be taken from IdentifierUse
                    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                    Identifies the purpose for this identifier, if known .

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    36. EpisodeOfCare.identifier:icpclaimnumber.type
                    Definition

                    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                    ShortDescription of identifier
                    Comments

                    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                    (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                    A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows users to make use of identifiers when the identifier system is not known.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    38. EpisodeOfCare.identifier:icpclaimnumber.system
                    Definition

                    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                    ShortThe namespace for the identifier value
                    Comments

                    Identifier.system is always case sensitive.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                    Fixed Valuehttps://standards.digital.health.nz/ns/acc-45-number
                    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    40. EpisodeOfCare.identifier:icpclaimnumber.value
                    Definition

                    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                    ShortThe ACC 45 number.
                    Comments

                    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                    Control1..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Example<br/><b>General</b>:123456
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    acc-claim-number: The claim number format is invalid; it must be in the form A999999, AA99999, 9999AAA or 99999AA, where A is any capital letter, 9 is any single digit, and there are 7 characters altogether. ($this.toString().matches('^[A-Z][0-9]{6}$|^[A-Z]{2}[0-9]{5}$|^[0-9]{4}[A-Z]{3}$|^[0-9]{5}[A-Z]{2}$'))
                    42. EpisodeOfCare.identifier:icpclaimnumber.period
                    Definition

                    Time period during which identifier is/was valid for use.

                    ShortTime period when id is/was valid for use
                    Control0..0
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    44. EpisodeOfCare.identifier:icpclaimnumber.assigner
                    Definition

                    Organization that issued/manages the identifier.

                    ShortOrganization that issued id (may be just text)
                    Comments

                    The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                    Control0..0
                    TypeReference(Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    46. EpisodeOfCare.status
                    Definition

                    The Status of the ICP case (must be Active).

                    Shortactive | finished
                    Comments

                    This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid.

                    Control1..1
                    BindingThe codes SHALL be taken from Status
                    (required to http://hl7.org.nz/fhir/ValueSet/acc-icp-episodeofcare-status)
                    Typecode
                    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    48. EpisodeOfCare.statusHistory
                    Definition

                    The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource).

                    ShortPast list of status codes (the current status may be included to cover the start date of the status)
                    Control0..0
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    55. EpisodeOfCare.type
                    Definition

                    A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care.

                    ShortThe type of ICP service. Currently only musculoskeletal (msk) is allowed, with more to be added in the future, e.g. concussion.
                    Comments

                    The type can be very important in processing as this could be used in determining if the EpisodeOfCare is relevant to specific government reporting, or other types of classifications.

                    Control0..0
                    BindingFor example codes, see EpisodeOfCareType
                    (example to http://hl7.org/fhir/ValueSet/episodeofcare-type)

                    The type of the episode of care.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. EpisodeOfCare.diagnosis
                    Definition

                    The list of diagnosis relevant to this episode of care.

                    ShortThe list of diagnosis relevant to this episode of care
                    Control0..0
                    TypeBackboneElement
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    76. EpisodeOfCare.patient
                    Definition

                    The patient who is the focus of this episode of care.

                    ShortThe patient who is the focus of this episode of care
                    Control1..1
                    TypeReference(ACC ICP Patient)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    78. EpisodeOfCare.managingOrganization
                    Definition

                    The organization that has assumed the specific responsibilities for the specified duration.

                    ShortThis is the ACC Vendor ID, in most cases this is the organisation's HPI ID.
                    Control1..1
                    TypeReference(Organization)
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    80. EpisodeOfCare.period
                    Definition

                    The interval during which the managing organization assumes the defined responsibility.

                    ShortInterval during responsibility is assumed
                    Control0..0
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    86. EpisodeOfCare.referralRequest
                    Definition

                    Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals.

                    ShortOriginating Referral Request(s)
                    Control0..0
                    TypeReference(ServiceRequest)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    88. EpisodeOfCare.careManager
                    Definition

                    The practitioner that is the care manager/care coordinator for this patient.

                    ShortCare manager/care coordinator for the patient
                    Control0..0
                    TypeReference(Practitioner, PractitionerRole)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    90. EpisodeOfCare.team
                    Definition

                    The list of practitioners that may be facilitating this episode of care for specific purposes.

                    ShortOther practitioners facilitating this episode of care
                    Control0..0
                    TypeReference(CareTeam)
                    Is Modifierfalse
                    Summaryfalse
                    Alternate NamesCareTeam
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    92. EpisodeOfCare.account
                    Definition

                    The set of accounts that may be used for billing for this EpisodeOfCare.

                    ShortThe set of accounts that may be used for billing for this EpisodeOfCare
                    Comments

                    The billing system may choose to allocate billable items associated with the EpisodeOfCare to different referenced Accounts based on internal business rules.

                    Control0..0
                    TypeReference(Account)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))