DK MedCom Carecommunication
4.0.3 - release Denmark flag

DK MedCom Carecommunication, published by MedCom. This guide is not an authorized publication; it is the continuous build for version 4.0.3 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/medcomdk/dk-medcom-carecommunication/ and changes regularly. See the Directory of published versions

Resource Profile: MedComCareCommunication - Detailed Descriptions

Active as of 2025-09-23

Definitions for the medcom-careCommunication-communication resource profile.

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

0. Communication
Definition

An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency that was notified about a reportable condition.

ShortA record of information transmitted from a sender to a receiver
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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())
medcom-careCommunication-5: Priority must not be present when Communication.category is other than 'regarding-referral' (where(category.coding.code != 'regarding-referral').priority.empty())
medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' (iif(category.coding.code != 'other', true, category.coding.code = 'other' and topic.exists()))
medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. (payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().code.coding.code.exists() xor payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().code.text.exists())
medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. (payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().practitioner.resolve().name.exists())
medcom-careCommunication-9: An episodeOfCare-identifier must be included when an Encounter instance is included. (iif(encounter.exists().not(), true, encounter.reference.resolve().episodeOfCare.identifier.exists()))
medcom-careCommunication-15: If an Encounter resource is present in the bundle, there must be a reference to it in Communication.encounter. If no Encounter is present, Communication.encounter must not be populated. (iif(encounter.exists(), Communication.encounter.reference.exists(), Communication.encounter.exists().not()))
2. Communication.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
Typeidstring
Is Modifierfalse
Must Supporttrue
Obligations
    ObligationsActor
    SHALL:in-narrativeProducer of FHIR resources
    Summarytrue
    4. Communication.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    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()))
    6. Communication.text
    Definition

    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

    ShortThe narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. For Governance of MedCom Narratives, see https://medcomdk.github.io/MedCom-FHIR-Communication/assets/documents/050_Governance-for-MedCom-FHIR-Messages.html#6-narrative-texts.Text 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
    Must Supporttrue
    Summaryfalse
    Alternate Namesnarrative, html, xhtml, display
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    8. Communication.text.status
    Definition

    The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

    Shortgenerated | extensions | additional | empty
    Control1..1
    BindingThe codes SHALL be taken from NarrativeStatushttp://hl7.org/fhir/ValueSet/narrative-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/narrative-status|4.0.1)

    The status of a resource narrative.

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

    The actual narrative content, a stripped down version of XHTML.

    ShortLimited xhtml content
    Comments

    The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

    Control1..1
    Typexhtml
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
    txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
    txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
    txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
    12. Communication.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.

    Control0..*
    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 Communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 14. Communication.extension:sender
      Slice Namesender
      Definition

      Reference to a more specfic sender of a message.

      ShortSenderExtension
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(SenderExtension) (Extension Type: Reference(MedComCorePractitionerRole, MedComCoreCareTeam)bundled)
      Is Modifierfalse
      Must Supporttrue
      Obligations
        ObligationsActor
        SHALL:in-narrativeProducer of FHIR resources
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. Communication.modifierExtension
        Definition

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

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

        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. Communication.identifier
        Definition

        Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

        ShortThe communication identifierUnique identifier
        Comments

        This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..1*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        medcom-uuidv4: The value shall correspond to the structure of an UUID version 4 (value.matches('urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[0-9a-f]{4}-[0-9a-f]{4}-[0-9a-f]{12}'))
        20. Communication.identifier.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()))
        22. Communication.identifier.value
        Definition

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

        ShortThe 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
        Must Supporttrue
        Summarytrue
        ExampleGeneral: 123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Communication.status
        Definition

        The status of the transmission.

        Shortpreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
        Comments

        This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.

        Control1..1
        BindingThe codes SHALL be taken from EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

        The status of the communication.

        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
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:in-narrativeProducer of FHIR resources
          Summarytrue
          Pattern Valueunknown
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. Communication.category
          Definition

          The type of message conveyed such as alert, notification, reminder, instruction, etc.

          ShortThe category (Danish: kategori) describes the overall content of the message.Message category
          Comments

          There may be multiple axes of categorization and one communication may serve multiple purposes.

          Control10..1*
          BindingThe codes SHALL be taken from For example codes, see MedComCareCommunicationCategoryCodeshttp://hl7.org/fhir/ValueSet/communication-category|4.0.1
          (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. Communication.category.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control0..*
          TypeCoding
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. Communication.category.coding.system
          Definition

          The identification of the code system that defines the meaning of the symbol in the code.

          ShortIdentity of the terminology system
          Comments

          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

          Need to be unambiguous about the source of the definition of the symbol.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Communication.category.coding.code
          Definition

          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          ShortSymbol in syntax defined by the system
          Control10..1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:in-narrativeProducer of FHIR resources
            Summarytrue
            Requirements

            Need to refer to a particular code in the system.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Communication.priority
            Definition

            Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.

            ShortShall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5routine | urgent | asap | stat
            Comments

            Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.

            Control0..1
            BindingThe codes SHALL be taken from MedComCareCommunicationRequestPriorityCodeshttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
            (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority)
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:in-narrativeProducer of FHIR resources
              Summarytrue
              Meaning if MissingIf missing, this communication should be treated with normal priority
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. Communication.subject
              Definition

              The patient or group that was the focus of this communication.

              ShortFocus of message
              Control10..1
              TypeReference(MedComCorePatient, Patient, Group)bundled
              Is Modifierfalse
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:in-narrativeProducer of FHIR resources
                Summarytrue
                Alternate Namespatient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. Communication.topic
                Definition

                Description of the purpose/content, similar to a subject line in an email.

                ShortThe topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element.Description of the purpose/content
                Comments

                Communication.topic.text can be used without any codings.

                Control0..1
                BindingFor example codes, see CommunicationTopichttp://hl7.org/fhir/ValueSet/communication-topic|4.0.1
                (example to http://hl7.org/fhir/ValueSet/communication-topic|4.0.1)

                Codes describing the purpose or content of the communication.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. Communication.topic.text
                Definition

                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                ShortPlain text representation of the concept
                Comments

                Very often the text is the same as a displayName of one of the codings.

                Control10..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:in-narrativeProducer of FHIR resources
                  Summarytrue
                  Requirements

                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  42. Communication.encounter
                  Definition

                  The Encounter during which this Communication was created or to which the creation of this record is tightly associated.

                  ShortShall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message.Encounter created as part of
                  Comments

                  This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                  Control0..1
                  TypeReference(MedComCoreEncounter, Encounter)bundled
                  Is Modifierfalse
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:in-narrativeProducer of FHIR resources
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    44. Communication.recipient
                    Definition

                    The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).

                    ShortDescribes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.Message recipient
                    Control0..1*
                    TypeReference(MedComCorePractitionerRole, MedComCoreCareTeam, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Group, CareTeam, HealthcareService)bundled
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Obligations
                      ObligationsActor
                      SHALL:in-narrativeProducer of FHIR resources
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      46. Communication.payload
                      Definition

                      Text, attachment(s), or resource(s) that was communicated to the recipient.

                      ShortEach payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included.Message payload
                      Control10..*
                      TypeBackboneElement
                      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 Communication.payload. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • type @ $this.content
                      • 48. Communication.payload.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..*
                        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 Communication.payload.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 50. Communication.payload.extension:date
                          Slice Namedate
                          Definition

                          Date and time of this payload

                          ShortDateTimeExtension
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                          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())
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          52. Communication.payload.extension:author
                          Slice Nameauthor
                          Definition

                          Reference to a PractitionerRole and subsequent Practitioner

                          ShortPractitionerExtension
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                          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())
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          54. Communication.payload.extension:authorContact
                          Slice NameauthorContact
                          Definition

                          Extension that contains the contact information

                          ShortContactExtension
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                          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())
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          56. Communication.payload.extension:identifier
                          Slice Nameidentifier
                          Definition

                          An extension holding a specific identifier datatype

                          ShortIdentifierExtension
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                          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())
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          58. Communication.payload.modifierExtension
                          Definition

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

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

                          ShortExtensions that cannot be ignored even if unrecognized
                          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 element that contains them
                          Summarytrue
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content, modifiers
                          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())
                          60. Communication.payload.content[x]
                          Definition

                          A communicated content (or for multi-part communications, one portion of the communication).

                          ShortMessage part content
                          Control1..1
                          TypeChoice of: string, Attachment, Reference(Resource)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          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()))
                          62. Communication.payload:string
                          Slice Namestring
                          Definition

                          Text, attachment(s), or resource(s) that was communicated to the recipient.

                          ShortMessage payload
                          Control10..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          64. Communication.payload:string.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.

                          Control40..*
                          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 Communication.payload.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 66. Communication.payload:string.extension:date
                            Slice Namedate
                            Definition

                            Date and time of this payload

                            ShortDateTimeExtension
                            Control1..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                            Is Modifierfalse
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:in-narrativeProducer of FHIR resources
                              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())
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              68. Communication.payload:string.extension:author
                              Slice Nameauthor
                              Definition

                              Reference to a PractitionerRole and subsequent Practitioner

                              ShortPractitionerExtension
                              Control1..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                              Is Modifierfalse
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:in-narrativeProducer of FHIR resources
                                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())
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                70. Communication.payload:string.extension:authorContact
                                Slice NameauthorContact
                                Definition

                                Extension that contains the contact information

                                ShortContactExtension
                                Control1..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                                Is Modifierfalse
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:in-narrativeProducer of FHIR resources
                                  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())
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  72. Communication.payload:string.extension:identifier
                                  Slice Nameidentifier
                                  Definition

                                  An extension holding a specific identifier datatype

                                  ShortIdentifierExtension
                                  Control1..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  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())
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  74. Communication.payload:string.modifierExtension
                                  Definition

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

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  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 element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  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())
                                  76. Communication.payload:string.content[x]
                                  Definition

                                  A communicated content (or for multi-part communications, one portion of the communication).

                                  ShortLine breaks must be represented as in FHIR JSON and as &#xA; in FHIR XML.Message part content
                                  Control1..1
                                  Typestring, Reference(Resource), Attachment
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:in-narrativeProducer of FHIR resources
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    78. Communication.payload:attachment
                                    Slice Nameattachment
                                    Definition

                                    Text, attachment(s), or resource(s) that was communicated to the recipient.

                                    ShortThe payload with an attachment shall contain a link or content attached to the message.Message payload
                                    Control0..*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    80. Communication.payload:attachment.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.

                                    Control20..*
                                    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 Communication.payload.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 82. Communication.payload:attachment.extension:date
                                      Slice Namedate
                                      Definition

                                      Date and time of this payload

                                      ShortDateTimeExtension
                                      Control1..1
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:in-narrativeProducer of FHIR resources
                                        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())
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        84. Communication.payload:attachment.extension:author
                                        Slice Nameauthor
                                        Definition

                                        Reference to a PractitionerRole and subsequent Practitioner

                                        ShortPractitionerExtension
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Obligations
                                          ObligationsActor
                                          SHALL:in-narrativeProducer of FHIR resources
                                          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())
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          86. Communication.payload:attachment.extension:authorContact
                                          Slice NameauthorContact
                                          Definition

                                          Extension that contains the contact information

                                          ShortContactExtension
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:in-narrativeProducer of FHIR resources
                                            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())
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            88. Communication.payload:attachment.extension:identifier
                                            Slice Nameidentifier
                                            Definition

                                            An extension holding a specific identifier datatype

                                            ShortIdentifierExtension
                                            Control1..1
                                            This element is affected by the following invariants: ele-1
                                            TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            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())
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            90. Communication.payload:attachment.modifierExtension
                                            Definition

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            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 element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            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())
                                            92. Communication.payload:attachment.content[x]
                                            Definition

                                            A communicated content (or for multi-part communications, one portion of the communication).

                                            ShortMessage part content
                                            Control1..1
                                            TypeAttachment, string, Reference(Resource)
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            94. Communication.payload:attachment.content[x].contentType
                                            Definition

                                            Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

                                            ShortThe content type shall be present when the content is an attachment included in the data element.Mime type of the content, with charset etc.
                                            Control0..1
                                            BindingThe codes SHALL be taken from MedComCoreAttachmentMimeTypeshttp://hl7.org/fhir/ValueSet/mimetypes|4.0.1
                                            (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes)
                                            Typecode
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActor
                                              SHALL:in-narrativeProducer of FHIR resources
                                              Summarytrue
                                              Requirements

                                              Processors of the data need to be able to know how to interpret the data.

                                              ExampleGeneral: text/plain; charset=UTF-8, image/png
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              96. Communication.payload:attachment.content[x].data
                                              Definition

                                              The actual data of the attachment - a sequence of bytes, base64 encoded.

                                              ShortShall be present and contain the base64 encoded content of the attachment.Data inline, base64ed
                                              Comments

                                              The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

                                              Control0..1
                                              Typebase64Binary
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              The data needs to able to be transmitted inline.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              98. Communication.payload:attachment.content[x].url
                                              Definition

                                              A location where the data can be accessed.

                                              ShortShall be present if the attachment is a link to a web page.Uri where the data can be found
                                              Comments

                                              If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

                                              Control0..1
                                              Typeurl
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:in-narrativeProducer of FHIR resources
                                                Summarytrue
                                                Requirements

                                                The data needs to be transmitted by reference.

                                                ExampleGeneral: http://www.acme.com/logo-small.png
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                100. Communication.payload:attachment.content[x].title
                                                Definition

                                                A label or set of text to display in place of the data.

                                                ShortNote: it is not allowed for the system to automatically include '.filetype' in the title.Label to display in place of the data
                                                Control10..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:in-narrativeProducer of FHIR resources
                                                  Summarytrue
                                                  Requirements

                                                  Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

                                                  ExampleGeneral: Official Corporate Logo
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  102. Communication.payload:attachment.content[x].creation
                                                  Definition

                                                  The date that the attachment was first created.

                                                  ShortThe time the attachment was createdDate attachment was first created
                                                  Control0..1
                                                  TypedateTime
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:in-narrativeProducer of FHIR resources
                                                    Summarytrue
                                                    Requirements

                                                    This is often tracked as an integrity issue for use of the attachment.

                                                    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 foundhere

                                                    0. Communication
                                                    Invariantsmedcom-careCommunication-5: Priority must not be present when Communication.category is other than 'regarding-referral' (where(category.coding.code != 'regarding-referral').priority.empty())
                                                    medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' (iif(category.coding.code != 'other', true, category.coding.code = 'other' and topic.exists()))
                                                    medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. (payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().code.coding.code.exists() xor payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().code.text.exists())
                                                    medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. (payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().practitioner.resolve().name.exists())
                                                    medcom-careCommunication-9: An episodeOfCare-identifier must be included when an Encounter instance is included. (iif(encounter.exists().not(), true, encounter.reference.resolve().episodeOfCare.identifier.exists()))
                                                    medcom-careCommunication-15: If an Encounter resource is present in the bundle, there must be a reference to it in Communication.encounter. If no Encounter is present, Communication.encounter must not be populated. (iif(encounter.exists(), Communication.encounter.reference.exists(), Communication.encounter.exists().not()))
                                                    2. Communication.id
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:in-narrativeProducer of FHIR resources
                                                      4. Communication.text
                                                      ShortThe narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. For Governance of MedCom Narratives, see https://medcomdk.github.io/MedCom-FHIR-Communication/assets/documents/050_Governance-for-MedCom-FHIR-Messages.html#6-narrative-texts.
                                                      Must Supporttrue
                                                      6. Communication.text.status
                                                      Must Supporttrue
                                                      8. Communication.text.div
                                                      Must Supporttrue
                                                      10. Communication.extension
                                                      SlicingThis element introduces a set of slices on Communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 12. Communication.extension:sender
                                                        Slice Namesender
                                                        Control0..1
                                                        TypeExtension(SenderExtension) (Extension Type: Reference(MedComCorePractitionerRole, MedComCoreCareTeam)bundled)
                                                        Must Supporttrue
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:in-narrativeProducer of FHIR resources
                                                          14. Communication.identifier
                                                          ShortThe communication identifier
                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                          Control1..1
                                                          Must Supporttrue
                                                          Invariantsmedcom-uuidv4: The value shall correspond to the structure of an UUID version 4 (value.matches('urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[0-9a-f]{4}-[0-9a-f]{4}-[0-9a-f]{12}'))
                                                          16. Communication.identifier.value
                                                          Control1..?
                                                          Must Supporttrue
                                                          18. Communication.status
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:in-narrativeProducer of FHIR resources
                                                            Pattern Valueunknown
                                                            20. Communication.category
                                                            ShortThe category (Danish: kategori) describes the overall content of the message.
                                                            Control1..1
                                                            BindingThe codes SHALL be taken from MedComCareCommunicationCategoryCodes
                                                            (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories)
                                                            Must Supporttrue
                                                            22. Communication.category.coding
                                                            Must Supporttrue
                                                            24. Communication.category.coding.system
                                                            Control1..?
                                                            Must Supporttrue
                                                            26. Communication.category.coding.code
                                                            Control1..?
                                                            Must Supporttrue
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:in-narrativeProducer of FHIR resources
                                                              28. Communication.priority
                                                              ShortShall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5
                                                              BindingThe codes SHALL be taken from MedComCareCommunicationRequestPriorityCodes
                                                              (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority)
                                                              Must Supporttrue
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:in-narrativeProducer of FHIR resources
                                                                30. Communication.subject
                                                                Control1..?
                                                                TypeReference(MedComCorePatient)bundled
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:in-narrativeProducer of FHIR resources
                                                                  32. Communication.topic
                                                                  ShortThe topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element.
                                                                  Must Supporttrue
                                                                  34. Communication.topic.text
                                                                  Control1..?
                                                                  Must Supporttrue
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:in-narrativeProducer of FHIR resources
                                                                    36. Communication.encounter
                                                                    ShortShall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message.
                                                                    TypeReference(MedComCoreEncounter)bundled
                                                                    Must Supporttrue
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:in-narrativeProducer of FHIR resources
                                                                      38. Communication.recipient
                                                                      ShortDescribes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.
                                                                      Control0..1
                                                                      TypeReference(MedComCorePractitionerRole, MedComCoreCareTeam)bundled
                                                                      Must Supporttrue
                                                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:in-narrativeProducer of FHIR resources
                                                                        40. Communication.payload
                                                                        ShortEach payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included.
                                                                        Control1..?
                                                                        SlicingThis element introduces a set of slices on Communication.payload. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • type @ $this.content
                                                                        • 42. Communication.payload.extension
                                                                          SlicingThis element introduces a set of slices on Communication.payload.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 44. Communication.payload.extension:date
                                                                            Slice Namedate
                                                                            Control0..1
                                                                            TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                                                                            46. Communication.payload.extension:author
                                                                            Slice Nameauthor
                                                                            Control0..1
                                                                            TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                                                                            48. Communication.payload.extension:authorContact
                                                                            Slice NameauthorContact
                                                                            Control0..1
                                                                            TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                                                                            50. Communication.payload.extension:identifier
                                                                            Slice Nameidentifier
                                                                            Control0..1
                                                                            TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                                                                            52. Communication.payload:string
                                                                            Slice Namestring
                                                                            Control1..*
                                                                            Must Supporttrue
                                                                            54. Communication.payload:string.extension
                                                                            Control4..?
                                                                            56. Communication.payload:string.extension:date
                                                                            Slice Namedate
                                                                            Control1..1
                                                                            TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                                                                            Must Supporttrue
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:in-narrativeProducer of FHIR resources
                                                                              58. Communication.payload:string.extension:author
                                                                              Slice Nameauthor
                                                                              Control1..1
                                                                              TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                                                                              Must Supporttrue
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:in-narrativeProducer of FHIR resources
                                                                                60. Communication.payload:string.extension:authorContact
                                                                                Slice NameauthorContact
                                                                                Control1..1
                                                                                TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                                                                                Must Supporttrue
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:in-narrativeProducer of FHIR resources
                                                                                  62. Communication.payload:string.extension:identifier
                                                                                  Slice Nameidentifier
                                                                                  Control1..1
                                                                                  TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                                                                                  Must Supporttrue
                                                                                  64. Communication.payload:string.content[x]
                                                                                  ShortLine breaks must be represented as in FHIR JSON and as &#xA; in FHIR XML.
                                                                                  Typestring
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Obligations
                                                                                    ObligationsActor
                                                                                    SHALL:in-narrativeProducer of FHIR resources
                                                                                    66. Communication.payload:attachment
                                                                                    Slice Nameattachment
                                                                                    ShortThe payload with an attachment shall contain a link or content attached to the message.
                                                                                    Control0..*
                                                                                    Must Supporttrue
                                                                                    68. Communication.payload:attachment.extension
                                                                                    Control2..?
                                                                                    70. Communication.payload:attachment.extension:date
                                                                                    Slice Namedate
                                                                                    Control1..1
                                                                                    TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                                                                                    Must Supporttrue
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:in-narrativeProducer of FHIR resources
                                                                                      72. Communication.payload:attachment.extension:author
                                                                                      Slice Nameauthor
                                                                                      Control0..1
                                                                                      TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                                                                                      Must Supporttrue
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:in-narrativeProducer of FHIR resources
                                                                                        74. Communication.payload:attachment.extension:authorContact
                                                                                        Slice NameauthorContact
                                                                                        Control0..1
                                                                                        TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:in-narrativeProducer of FHIR resources
                                                                                          76. Communication.payload:attachment.extension:identifier
                                                                                          Slice Nameidentifier
                                                                                          Control1..1
                                                                                          TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                                                                                          Must Supporttrue
                                                                                          78. Communication.payload:attachment.content[x]
                                                                                          TypeAttachment
                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                          Must Supporttrue
                                                                                          80. Communication.payload:attachment.content[x].contentType
                                                                                          ShortThe content type shall be present when the content is an attachment included in the data element.
                                                                                          BindingThe codes SHALL be taken from MedComCoreAttachmentMimeTypes
                                                                                          (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes)
                                                                                          Must Supporttrue
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:in-narrativeProducer of FHIR resources
                                                                                            82. Communication.payload:attachment.content[x].data
                                                                                            ShortShall be present and contain the base64 encoded content of the attachment.
                                                                                            Must Supporttrue
                                                                                            84. Communication.payload:attachment.content[x].url
                                                                                            ShortShall be present if the attachment is a link to a web page.
                                                                                            Must Supporttrue
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:in-narrativeProducer of FHIR resources
                                                                                              86. Communication.payload:attachment.content[x].title
                                                                                              ShortNote: it is not allowed for the system to automatically include '.filetype' in the title.
                                                                                              Control1..?
                                                                                              Must Supporttrue
                                                                                              Obligations
                                                                                                ObligationsActor
                                                                                                SHALL:in-narrativeProducer of FHIR resources
                                                                                                88. Communication.payload:attachment.content[x].creation
                                                                                                ShortThe time the attachment was created
                                                                                                Must Supporttrue
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHALL:in-narrativeProducer of FHIR resources

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

                                                                                                  0. Communication
                                                                                                  Definition

                                                                                                  An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency that was notified about a reportable condition.

                                                                                                  ShortA record of information transmitted from a sender to a receiver
                                                                                                  Control0..*
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                                                  dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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())
                                                                                                  medcom-careCommunication-5: Priority must not be present when Communication.category is other than 'regarding-referral' (where(category.coding.code != 'regarding-referral').priority.empty())
                                                                                                  medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' (iif(category.coding.code != 'other', true, category.coding.code = 'other' and topic.exists()))
                                                                                                  medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. (payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().code.coding.code.exists() xor payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().code.text.exists())
                                                                                                  medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. (payload.where(extension('http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension').exists()).extension.value.reference.resolve().practitioner.resolve().name.exists())
                                                                                                  medcom-careCommunication-9: An episodeOfCare-identifier must be included when an Encounter instance is included. (iif(encounter.exists().not(), true, encounter.reference.resolve().episodeOfCare.identifier.exists()))
                                                                                                  medcom-careCommunication-15: If an Encounter resource is present in the bundle, there must be a reference to it in Communication.encounter. If no Encounter is present, Communication.encounter must not be populated. (iif(encounter.exists(), Communication.encounter.reference.exists(), Communication.encounter.exists().not()))
                                                                                                  2. Communication.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
                                                                                                  Must Supporttrue
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    SHALL:in-narrativeProducer of FHIR resources
                                                                                                    Summarytrue
                                                                                                    4. Communication.meta
                                                                                                    Definition

                                                                                                    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                                                                    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. Communication.implicitRules
                                                                                                    Definition

                                                                                                    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                                                                    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. Communication.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|4.0.1)

                                                                                                    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. Communication.text
                                                                                                    Definition

                                                                                                    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                    ShortThe narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. For Governance of MedCom Narratives, see https://medcomdk.github.io/MedCom-FHIR-Communication/assets/documents/050_Governance-for-MedCom-FHIR-Messages.html#6-narrative-texts.
                                                                                                    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
                                                                                                    Must Supporttrue
                                                                                                    Summaryfalse
                                                                                                    Alternate Namesnarrative, html, xhtml, display
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    12. Communication.text.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..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    Summaryfalse
                                                                                                    14. Communication.text.extension
                                                                                                    Definition

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

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifierfalse
                                                                                                    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 Communication.text.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • value @ url
                                                                                                    • 16. Communication.text.status
                                                                                                      Definition

                                                                                                      The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

                                                                                                      Shortgenerated | extensions | additional | empty
                                                                                                      Control1..1
                                                                                                      BindingThe codes SHALL be taken from NarrativeStatus
                                                                                                      (required to http://hl7.org/fhir/ValueSet/narrative-status|4.0.1)

                                                                                                      The status of a resource narrative.

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

                                                                                                      The actual narrative content, a stripped down version of XHTML.

                                                                                                      ShortLimited xhtml content
                                                                                                      Comments

                                                                                                      The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

                                                                                                      Control1..1
                                                                                                      Typexhtml
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Must Supporttrue
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      txt-1: The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes (htmlChecks())
                                                                                                      txt-2: The narrative SHALL have some non-whitespace content (htmlChecks())
                                                                                                      20. Communication.contained
                                                                                                      Definition

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

                                                                                                      ShortContained, inline Resources
                                                                                                      Comments

                                                                                                      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                                                                      Control0..*
                                                                                                      TypeResource
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Alternate Namesinline resources, anonymous resources, contained resources
                                                                                                      22. Communication.extension
                                                                                                      Definition

                                                                                                      An Extension

                                                                                                      ShortExtension
                                                                                                      Control0..*
                                                                                                      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 Communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 24. Communication.extension:sender
                                                                                                        Slice Namesender
                                                                                                        Definition

                                                                                                        Reference to a more specfic sender of a message.

                                                                                                        ShortSenderExtension
                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeExtension(SenderExtension) (Extension Type: Reference(MedComCorePractitionerRole, MedComCoreCareTeam)bundled)
                                                                                                        Is Modifierfalse
                                                                                                        Must Supporttrue
                                                                                                        Obligations
                                                                                                          ObligationsActor
                                                                                                          SHALL:in-narrativeProducer of FHIR resources
                                                                                                          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())
                                                                                                          26. Communication.modifierExtension
                                                                                                          Definition

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

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

                                                                                                          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())
                                                                                                          28. Communication.identifier
                                                                                                          Definition

                                                                                                          Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

                                                                                                          ShortThe communication identifier
                                                                                                          Comments

                                                                                                          This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

                                                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                          Control1..1
                                                                                                          TypeIdentifier
                                                                                                          Is Modifierfalse
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          medcom-uuidv4: The value shall correspond to the structure of an UUID version 4 (value.matches('urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[0-9a-f]{4}-[0-9a-f]{4}-[0-9a-f]{12}'))
                                                                                                          30. Communication.identifier.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..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          Summaryfalse
                                                                                                          32. Communication.identifier.extension
                                                                                                          Definition

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

                                                                                                          ShortAdditional content defined by implementations
                                                                                                          Comments

                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifierfalse
                                                                                                          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 Communication.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 34. Communication.identifier.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. Communication.identifier.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|4.0.1)

                                                                                                            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. Communication.identifier.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.

                                                                                                            Control0..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.

                                                                                                            ExampleGeneral: http://www.acme.com/identifiers/patient
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            40. Communication.identifier.value
                                                                                                            Definition

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

                                                                                                            ShortThe 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.

                                                                                                            Control1..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            ExampleGeneral: 123456
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            42. Communication.identifier.period
                                                                                                            Definition

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

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

                                                                                                            The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.

                                                                                                            ShortInstantiates FHIR protocol or definition
                                                                                                            Control0..*
                                                                                                            Typecanonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire)
                                                                                                            Is Modifierfalse
                                                                                                            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. Communication.instantiatesUri
                                                                                                            Definition

                                                                                                            The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.

                                                                                                            ShortInstantiates external protocol or definition
                                                                                                            Comments

                                                                                                            This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

                                                                                                            Control0..*
                                                                                                            Typeuri
                                                                                                            Is Modifierfalse
                                                                                                            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()))
                                                                                                            50. Communication.basedOn
                                                                                                            Definition

                                                                                                            An order, proposal or plan fulfilled in whole or in part by this Communication.

                                                                                                            ShortRequest fulfilled by this communication
                                                                                                            Comments

                                                                                                            This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc.

                                                                                                            Control0..*
                                                                                                            TypeReference(Resource)
                                                                                                            Is Modifierfalse
                                                                                                            Summarytrue
                                                                                                            Alternate Namesfulfills
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            52. Communication.partOf
                                                                                                            Definition

                                                                                                            Part of this action.

                                                                                                            ShortPart of this action
                                                                                                            Control0..*
                                                                                                            TypeReference(Resource)
                                                                                                            Is Modifierfalse
                                                                                                            Summarytrue
                                                                                                            Alternate Namescontainer
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            54. Communication.inResponseTo
                                                                                                            Definition

                                                                                                            Prior communication that this communication is in response to.

                                                                                                            ShortReply to
                                                                                                            Control0..*
                                                                                                            TypeReference(Communication)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            56. Communication.status
                                                                                                            Definition

                                                                                                            The status of the transmission.

                                                                                                            Shortpreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
                                                                                                            Comments

                                                                                                            This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.

                                                                                                            Control1..1
                                                                                                            BindingThe codes SHALL be taken from EventStatus
                                                                                                            (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

                                                                                                            The status of the communication.

                                                                                                            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
                                                                                                            Must Supporttrue
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:in-narrativeProducer of FHIR resources
                                                                                                              Summarytrue
                                                                                                              Pattern Valueunknown
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              58. Communication.statusReason
                                                                                                              Definition

                                                                                                              Captures the reason for the current state of the Communication.

                                                                                                              ShortReason for current status
                                                                                                              Comments

                                                                                                              This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

                                                                                                              Control0..1
                                                                                                              BindingFor example codes, see CommunicationNotDoneReason
                                                                                                              (example to http://hl7.org/fhir/ValueSet/communication-not-done-reason|4.0.1)

                                                                                                              Codes for the reason why a communication did not happen.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summarytrue
                                                                                                              Alternate NamesSuspended Reason, Cancelled Reason
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              60. Communication.category
                                                                                                              Definition

                                                                                                              The type of message conveyed such as alert, notification, reminder, instruction, etc.

                                                                                                              ShortThe category (Danish: kategori) describes the overall content of the message.
                                                                                                              Comments

                                                                                                              There may be multiple axes of categorization and one communication may serve multiple purposes.

                                                                                                              Control1..1
                                                                                                              BindingThe codes SHALL be taken from MedComCareCommunicationCategoryCodes
                                                                                                              (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories)
                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Must Supporttrue
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              62. Communication.category.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..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              Summaryfalse
                                                                                                              64. Communication.category.extension
                                                                                                              Definition

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

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              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 Communication.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 66. Communication.category.coding
                                                                                                                Definition

                                                                                                                A reference to a code defined by a terminology system.

                                                                                                                ShortCode defined by a terminology system
                                                                                                                Comments

                                                                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                Control0..*
                                                                                                                TypeCoding
                                                                                                                Is Modifierfalse
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                68. Communication.category.coding.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..1
                                                                                                                Typestring
                                                                                                                Is Modifierfalse
                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                Summaryfalse
                                                                                                                70. Communication.category.coding.extension
                                                                                                                Definition

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

                                                                                                                ShortAdditional content defined by implementations
                                                                                                                Comments

                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                Control0..*
                                                                                                                TypeExtension
                                                                                                                Is Modifierfalse
                                                                                                                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 Communication.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ url
                                                                                                                • 72. Communication.category.coding.system
                                                                                                                  Definition

                                                                                                                  The identification of the code system that defines the meaning of the symbol in the code.

                                                                                                                  ShortIdentity of the terminology system
                                                                                                                  Comments

                                                                                                                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                                                                                                  Need to be unambiguous about the source of the definition of the symbol.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  74. Communication.category.coding.version
                                                                                                                  Definition

                                                                                                                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                                                                                  ShortVersion of the system - if relevant
                                                                                                                  Comments

                                                                                                                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                                                                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                                                  Control0..1
                                                                                                                  Typestring
                                                                                                                  Is Modifierfalse
                                                                                                                  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()))
                                                                                                                  76. Communication.category.coding.code
                                                                                                                  Definition

                                                                                                                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                                                                                  ShortSymbol in syntax defined by the system
                                                                                                                  Control1..1
                                                                                                                  Typecode
                                                                                                                  Is Modifierfalse
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Must Supporttrue
                                                                                                                  Obligations
                                                                                                                    ObligationsActor
                                                                                                                    SHALL:in-narrativeProducer of FHIR resources
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    Need to refer to a particular code in the system.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    78. Communication.category.coding.display
                                                                                                                    Definition

                                                                                                                    A representation of the meaning of the code in the system, following the rules of the system.

                                                                                                                    ShortRepresentation defined by the system
                                                                                                                    Control0..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    80. Communication.category.coding.userSelected
                                                                                                                    Definition

                                                                                                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                                                                                    ShortIf this coding was chosen directly by the user
                                                                                                                    Comments

                                                                                                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                                                                                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    82. Communication.category.text
                                                                                                                    Definition

                                                                                                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                    ShortPlain text representation of the concept
                                                                                                                    Comments

                                                                                                                    Very often the text is the same as a displayName of one of the codings.

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

                                                                                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    84. Communication.priority
                                                                                                                    Definition

                                                                                                                    Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.

                                                                                                                    ShortShall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5
                                                                                                                    Comments

                                                                                                                    Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.

                                                                                                                    Control0..1
                                                                                                                    BindingThe codes SHALL be taken from MedComCareCommunicationRequestPriorityCodes
                                                                                                                    (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority)
                                                                                                                    Typecode
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Must Supporttrue
                                                                                                                    Obligations
                                                                                                                      ObligationsActor
                                                                                                                      SHALL:in-narrativeProducer of FHIR resources
                                                                                                                      Summarytrue
                                                                                                                      Meaning if MissingIf missing, this communication should be treated with normal priority
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      86. Communication.medium
                                                                                                                      Definition

                                                                                                                      A channel that was used for this communication (e.g. email, fax).

                                                                                                                      ShortA channel of communication
                                                                                                                      Control0..*
                                                                                                                      BindingFor example codes, see ParticipationMode
                                                                                                                      (example to http://terminology.hl7.org/ValueSet/v3-ParticipationMode)

                                                                                                                      Codes for communication mediums such as phone, fax, email, in person, etc.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      88. Communication.subject
                                                                                                                      Definition

                                                                                                                      The patient or group that was the focus of this communication.

                                                                                                                      ShortFocus of message
                                                                                                                      Control1..1
                                                                                                                      TypeReference(MedComCorePatient)bundled
                                                                                                                      Is Modifierfalse
                                                                                                                      Must Supporttrue
                                                                                                                      Obligations
                                                                                                                        ObligationsActor
                                                                                                                        SHALL:in-narrativeProducer of FHIR resources
                                                                                                                        Summarytrue
                                                                                                                        Alternate Namespatient
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        90. Communication.topic
                                                                                                                        Definition

                                                                                                                        Description of the purpose/content, similar to a subject line in an email.

                                                                                                                        ShortThe topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element.
                                                                                                                        Comments

                                                                                                                        Communication.topic.text can be used without any codings.

                                                                                                                        Control0..1
                                                                                                                        BindingFor example codes, see CommunicationTopic
                                                                                                                        (example to http://hl7.org/fhir/ValueSet/communication-topic|4.0.1)

                                                                                                                        Codes describing the purpose or content of the communication.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Is Modifierfalse
                                                                                                                        Must Supporttrue
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        92. Communication.topic.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..1
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                        Summaryfalse
                                                                                                                        94. Communication.topic.extension
                                                                                                                        Definition

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

                                                                                                                        ShortAdditional content defined by implementations
                                                                                                                        Comments

                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                        Control0..*
                                                                                                                        TypeExtension
                                                                                                                        Is Modifierfalse
                                                                                                                        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 Communication.topic.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                        • value @ url
                                                                                                                        • 96. Communication.topic.coding
                                                                                                                          Definition

                                                                                                                          A reference to a code defined by a terminology system.

                                                                                                                          ShortCode defined by a terminology system
                                                                                                                          Comments

                                                                                                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                                          Control0..*
                                                                                                                          TypeCoding
                                                                                                                          Is Modifierfalse
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          98. Communication.topic.text
                                                                                                                          Definition

                                                                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                                          ShortPlain text representation of the concept
                                                                                                                          Comments

                                                                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                                                                          Control1..1
                                                                                                                          Typestring
                                                                                                                          Is Modifierfalse
                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                          Must Supporttrue
                                                                                                                          Obligations
                                                                                                                            ObligationsActor
                                                                                                                            SHALL:in-narrativeProducer of FHIR resources
                                                                                                                            Summarytrue
                                                                                                                            Requirements

                                                                                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            100. Communication.about
                                                                                                                            Definition

                                                                                                                            Other resources that pertain to this communication and to which this communication should be associated.

                                                                                                                            ShortResources that pertain to this communication
                                                                                                                            Comments

                                                                                                                            Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.

                                                                                                                            Control0..*
                                                                                                                            TypeReference(Resource)
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            102. Communication.encounter
                                                                                                                            Definition

                                                                                                                            The Encounter during which this Communication was created or to which the creation of this record is tightly associated.

                                                                                                                            ShortShall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message.
                                                                                                                            Comments

                                                                                                                            This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                                                                                                            Control0..1
                                                                                                                            TypeReference(MedComCoreEncounter)bundled
                                                                                                                            Is Modifierfalse
                                                                                                                            Must Supporttrue
                                                                                                                            Obligations
                                                                                                                              ObligationsActor
                                                                                                                              SHALL:in-narrativeProducer of FHIR resources
                                                                                                                              Summarytrue
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              104. Communication.sent
                                                                                                                              Definition

                                                                                                                              The time when this communication was sent.

                                                                                                                              ShortWhen sent
                                                                                                                              Control0..1
                                                                                                                              TypedateTime
                                                                                                                              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()))
                                                                                                                              106. Communication.received
                                                                                                                              Definition

                                                                                                                              The time when this communication arrived at the destination.

                                                                                                                              ShortWhen received
                                                                                                                              Control0..1
                                                                                                                              TypedateTime
                                                                                                                              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()))
                                                                                                                              108. Communication.recipient
                                                                                                                              Definition

                                                                                                                              The entity (e.g. person, organization, clinical information system, care team or device) which was the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).

                                                                                                                              ShortDescribes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.
                                                                                                                              Control0..1
                                                                                                                              TypeReference(MedComCorePractitionerRole, MedComCoreCareTeam)bundled
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supporttrue
                                                                                                                              Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                                              Obligations
                                                                                                                                ObligationsActor
                                                                                                                                SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                Summaryfalse
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                110. Communication.sender
                                                                                                                                Definition

                                                                                                                                The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

                                                                                                                                ShortMessage sender
                                                                                                                                Control0..1
                                                                                                                                TypeReference(Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService)
                                                                                                                                Is Modifierfalse
                                                                                                                                Summaryfalse
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                112. Communication.reasonCode
                                                                                                                                Definition

                                                                                                                                The reason or justification for the communication.

                                                                                                                                ShortIndication for message
                                                                                                                                Comments

                                                                                                                                Textual reasons can be captured using reasonCode.text.

                                                                                                                                Control0..*
                                                                                                                                BindingFor example codes, see SNOMEDCTClinicalFindings
                                                                                                                                (example to http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1)

                                                                                                                                Codes for describing reasons for the occurrence of a communication.

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

                                                                                                                                Indicates another resource whose existence justifies this communication.

                                                                                                                                ShortWhy was communication done?
                                                                                                                                Control0..*
                                                                                                                                TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                                                                                                                                Is Modifierfalse
                                                                                                                                Summarytrue
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                116. Communication.payload
                                                                                                                                Definition

                                                                                                                                Text, attachment(s), or resource(s) that was communicated to the recipient.

                                                                                                                                ShortEach payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included.
                                                                                                                                Control1..*
                                                                                                                                TypeBackboneElement
                                                                                                                                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 Communication.payload. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                • type @ $this.content
                                                                                                                                • 118. Communication.payload.id
                                                                                                                                  Definition

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

                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                  Control0..1
                                                                                                                                  Typestring
                                                                                                                                  Is Modifierfalse
                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                  Summaryfalse
                                                                                                                                  120. Communication.payload.extension
                                                                                                                                  Definition

                                                                                                                                  An Extension

                                                                                                                                  ShortExtension
                                                                                                                                  Control0..*
                                                                                                                                  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 Communication.payload.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                  • value @ url
                                                                                                                                  • 122. Communication.payload.extension:date
                                                                                                                                    Slice Namedate
                                                                                                                                    Definition

                                                                                                                                    Date and time of this payload

                                                                                                                                    ShortDateTimeExtension
                                                                                                                                    Control0..1
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                                                                                                                                    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())
                                                                                                                                    124. Communication.payload.extension:author
                                                                                                                                    Slice Nameauthor
                                                                                                                                    Definition

                                                                                                                                    Reference to a PractitionerRole and subsequent Practitioner

                                                                                                                                    ShortPractitionerExtension
                                                                                                                                    Control0..1
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                                                                                                                                    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())
                                                                                                                                    126. Communication.payload.extension:authorContact
                                                                                                                                    Slice NameauthorContact
                                                                                                                                    Definition

                                                                                                                                    Extension that contains the contact information

                                                                                                                                    ShortContactExtension
                                                                                                                                    Control0..1
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                                                                                                                                    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())
                                                                                                                                    128. Communication.payload.extension:identifier
                                                                                                                                    Slice Nameidentifier
                                                                                                                                    Definition

                                                                                                                                    An extension holding a specific identifier datatype

                                                                                                                                    ShortIdentifierExtension
                                                                                                                                    Control0..1
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                                                                                                                                    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())
                                                                                                                                    130. Communication.payload.modifierExtension
                                                                                                                                    Definition

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

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

                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                    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 element that contains them
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                                    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())
                                                                                                                                    132. Communication.payload.content[x]
                                                                                                                                    Definition

                                                                                                                                    A communicated content (or for multi-part communications, one portion of the communication).

                                                                                                                                    ShortMessage part content
                                                                                                                                    Control1..1
                                                                                                                                    TypeChoice of: string, Attachment, Reference(Resource)
                                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                    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()))
                                                                                                                                    134. Communication.payload:string
                                                                                                                                    Slice Namestring
                                                                                                                                    Definition

                                                                                                                                    Text, attachment(s), or resource(s) that was communicated to the recipient.

                                                                                                                                    ShortMessage payload
                                                                                                                                    Control1..*
                                                                                                                                    TypeBackboneElement
                                                                                                                                    Is Modifierfalse
                                                                                                                                    Must Supporttrue
                                                                                                                                    Summaryfalse
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    136. Communication.payload:string.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..1
                                                                                                                                    Typestring
                                                                                                                                    Is Modifierfalse
                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                    Summaryfalse
                                                                                                                                    138. Communication.payload:string.extension
                                                                                                                                    Definition

                                                                                                                                    An Extension

                                                                                                                                    ShortExtension
                                                                                                                                    Control4..*
                                                                                                                                    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 Communication.payload.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                    • value @ url
                                                                                                                                    • 140. Communication.payload:string.extension:date
                                                                                                                                      Slice Namedate
                                                                                                                                      Definition

                                                                                                                                      Date and time of this payload

                                                                                                                                      ShortDateTimeExtension
                                                                                                                                      Control1..1
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supporttrue
                                                                                                                                      Obligations
                                                                                                                                        ObligationsActor
                                                                                                                                        SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                        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())
                                                                                                                                        142. Communication.payload:string.extension:author
                                                                                                                                        Slice Nameauthor
                                                                                                                                        Definition

                                                                                                                                        Reference to a PractitionerRole and subsequent Practitioner

                                                                                                                                        ShortPractitionerExtension
                                                                                                                                        Control1..1
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Must Supporttrue
                                                                                                                                        Obligations
                                                                                                                                          ObligationsActor
                                                                                                                                          SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                          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())
                                                                                                                                          144. Communication.payload:string.extension:authorContact
                                                                                                                                          Slice NameauthorContact
                                                                                                                                          Definition

                                                                                                                                          Extension that contains the contact information

                                                                                                                                          ShortContactExtension
                                                                                                                                          Control1..1
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                                                                                                                                          Is Modifierfalse
                                                                                                                                          Must Supporttrue
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActor
                                                                                                                                            SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                            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())
                                                                                                                                            146. Communication.payload:string.extension:identifier
                                                                                                                                            Slice Nameidentifier
                                                                                                                                            Definition

                                                                                                                                            An extension holding a specific identifier datatype

                                                                                                                                            ShortIdentifierExtension
                                                                                                                                            Control1..1
                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                            TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                                                                                                                                            Is Modifierfalse
                                                                                                                                            Must Supporttrue
                                                                                                                                            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())
                                                                                                                                            148. Communication.payload:string.modifierExtension
                                                                                                                                            Definition

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

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

                                                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                            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 element that contains them
                                                                                                                                            Summarytrue
                                                                                                                                            Requirements

                                                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                                                            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())
                                                                                                                                            150. Communication.payload:string.content[x]
                                                                                                                                            Definition

                                                                                                                                            A communicated content (or for multi-part communications, one portion of the communication).

                                                                                                                                            ShortLine breaks must be represented as in FHIR JSON and as &#xA; in FHIR XML.
                                                                                                                                            Control1..1
                                                                                                                                            Typestring
                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                            Is Modifierfalse
                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                            Must Supporttrue
                                                                                                                                            Obligations
                                                                                                                                              ObligationsActor
                                                                                                                                              SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                              Summaryfalse
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              152. Communication.payload:attachment
                                                                                                                                              Slice Nameattachment
                                                                                                                                              Definition

                                                                                                                                              Text, attachment(s), or resource(s) that was communicated to the recipient.

                                                                                                                                              ShortThe payload with an attachment shall contain a link or content attached to the message.
                                                                                                                                              Control0..*
                                                                                                                                              TypeBackboneElement
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Must Supporttrue
                                                                                                                                              Summaryfalse
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              154. Communication.payload:attachment.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..1
                                                                                                                                              Typestring
                                                                                                                                              Is Modifierfalse
                                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                              Summaryfalse
                                                                                                                                              156. Communication.payload:attachment.extension
                                                                                                                                              Definition

                                                                                                                                              An Extension

                                                                                                                                              ShortExtension
                                                                                                                                              Control2..*
                                                                                                                                              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 Communication.payload.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                              • value @ url
                                                                                                                                              • 158. Communication.payload:attachment.extension:date
                                                                                                                                                Slice Namedate
                                                                                                                                                Definition

                                                                                                                                                Date and time of this payload

                                                                                                                                                ShortDateTimeExtension
                                                                                                                                                Control1..1
                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                TypeExtension(DateTimeExtension) (Extension Type: dateTime)
                                                                                                                                                Is Modifierfalse
                                                                                                                                                Must Supporttrue
                                                                                                                                                Obligations
                                                                                                                                                  ObligationsActor
                                                                                                                                                  SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                                  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())
                                                                                                                                                  160. Communication.payload:attachment.extension:author
                                                                                                                                                  Slice Nameauthor
                                                                                                                                                  Definition

                                                                                                                                                  Reference to a PractitionerRole and subsequent Practitioner

                                                                                                                                                  ShortPractitionerExtension
                                                                                                                                                  Control0..1
                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                  TypeExtension(PractitionerExtension) (Extension Type: Reference(MedComCorePractitionerRole)bundled)
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Must Supporttrue
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActor
                                                                                                                                                    SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                                    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())
                                                                                                                                                    162. Communication.payload:attachment.extension:authorContact
                                                                                                                                                    Slice NameauthorContact
                                                                                                                                                    Definition

                                                                                                                                                    Extension that contains the contact information

                                                                                                                                                    ShortContactExtension
                                                                                                                                                    Control0..1
                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                    TypeExtension(ContactExtension) (Extension Type: ContactPoint)
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Must Supporttrue
                                                                                                                                                    Obligations
                                                                                                                                                      ObligationsActor
                                                                                                                                                      SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                                      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())
                                                                                                                                                      164. Communication.payload:attachment.extension:identifier
                                                                                                                                                      Slice Nameidentifier
                                                                                                                                                      Definition

                                                                                                                                                      An extension holding a specific identifier datatype

                                                                                                                                                      ShortIdentifierExtension
                                                                                                                                                      Control1..1
                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                      TypeExtension(IdentifierExtension) (Extension Type: Identifier)
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      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())
                                                                                                                                                      166. Communication.payload:attachment.modifierExtension
                                                                                                                                                      Definition

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

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

                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                      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 element that contains them
                                                                                                                                                      Summarytrue
                                                                                                                                                      Requirements

                                                                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                                                                      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())
                                                                                                                                                      168. Communication.payload:attachment.content[x]
                                                                                                                                                      Definition

                                                                                                                                                      A communicated content (or for multi-part communications, one portion of the communication).

                                                                                                                                                      ShortMessage part content
                                                                                                                                                      Control1..1
                                                                                                                                                      TypeAttachment
                                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      170. Communication.payload:attachment.content[x].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..1
                                                                                                                                                      Typestring
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                      Summaryfalse
                                                                                                                                                      172. Communication.payload:attachment.content[x].extension
                                                                                                                                                      Definition

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

                                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                                      Comments

                                                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                      Control0..*
                                                                                                                                                      TypeExtension
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      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 Communication.payload.content[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                      • value @ url
                                                                                                                                                      • 174. Communication.payload:attachment.content[x].contentType
                                                                                                                                                        Definition

                                                                                                                                                        Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

                                                                                                                                                        ShortThe content type shall be present when the content is an attachment included in the data element.
                                                                                                                                                        Control0..1
                                                                                                                                                        BindingThe codes SHALL be taken from MedComCoreAttachmentMimeTypes
                                                                                                                                                        (required to http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes)
                                                                                                                                                        Typecode
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Must Supporttrue
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActor
                                                                                                                                                          SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                                          Summarytrue
                                                                                                                                                          Requirements

                                                                                                                                                          Processors of the data need to be able to know how to interpret the data.

                                                                                                                                                          ExampleGeneral: text/plain; charset=UTF-8, image/png
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          176. Communication.payload:attachment.content[x].language
                                                                                                                                                          Definition

                                                                                                                                                          The human language of the content. The value can be any valid value according to BCP 47.

                                                                                                                                                          ShortHuman language of the content (BCP-47)
                                                                                                                                                          Control0..1
                                                                                                                                                          BindingThe codes SHOULD be taken from CommonLanguages
                                                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                                                                                                                                                          A human language.

                                                                                                                                                          Additional BindingsPurpose
                                                                                                                                                          AllLanguagesMax Binding
                                                                                                                                                          Typecode
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                          Summarytrue
                                                                                                                                                          Requirements

                                                                                                                                                          Users need to be able to choose between the languages in a set of attachments.

                                                                                                                                                          ExampleGeneral: en-AU
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          178. Communication.payload:attachment.content[x].data
                                                                                                                                                          Definition

                                                                                                                                                          The actual data of the attachment - a sequence of bytes, base64 encoded.

                                                                                                                                                          ShortShall be present and contain the base64 encoded content of the attachment.
                                                                                                                                                          Comments

                                                                                                                                                          The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

                                                                                                                                                          Control0..1
                                                                                                                                                          Typebase64Binary
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                          Must Supporttrue
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Requirements

                                                                                                                                                          The data needs to able to be transmitted inline.

                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          180. Communication.payload:attachment.content[x].url
                                                                                                                                                          Definition

                                                                                                                                                          A location where the data can be accessed.

                                                                                                                                                          ShortShall be present if the attachment is a link to a web page.
                                                                                                                                                          Comments

                                                                                                                                                          If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

                                                                                                                                                          Control0..1
                                                                                                                                                          Typeurl
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                          Must Supporttrue
                                                                                                                                                          Obligations
                                                                                                                                                            ObligationsActor
                                                                                                                                                            SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                                            Summarytrue
                                                                                                                                                            Requirements

                                                                                                                                                            The data needs to be transmitted by reference.

                                                                                                                                                            ExampleGeneral: http://www.acme.com/logo-small.png
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            182. Communication.payload:attachment.content[x].size
                                                                                                                                                            Definition

                                                                                                                                                            The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

                                                                                                                                                            ShortNumber of bytes of content (if url provided)
                                                                                                                                                            Comments

                                                                                                                                                            The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

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

                                                                                                                                                            Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            184. Communication.payload:attachment.content[x].hash
                                                                                                                                                            Definition

                                                                                                                                                            The calculated hash of the data using SHA-1. Represented using base64.

                                                                                                                                                            ShortHash of the data (sha-1, base64ed)
                                                                                                                                                            Comments

                                                                                                                                                            The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see Provenance.signature for mechanism to protect a resource with a digital signature.

                                                                                                                                                            Control0..1
                                                                                                                                                            Typebase64Binary
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                            Summarytrue
                                                                                                                                                            Requirements

                                                                                                                                                            Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            186. Communication.payload:attachment.content[x].title
                                                                                                                                                            Definition

                                                                                                                                                            A label or set of text to display in place of the data.

                                                                                                                                                            ShortNote: it is not allowed for the system to automatically include '.filetype' in the title.
                                                                                                                                                            Control1..1
                                                                                                                                                            Typestring
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                            Must Supporttrue
                                                                                                                                                            Obligations
                                                                                                                                                              ObligationsActor
                                                                                                                                                              SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                                              Summarytrue
                                                                                                                                                              Requirements

                                                                                                                                                              Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

                                                                                                                                                              ExampleGeneral: Official Corporate Logo
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              188. Communication.payload:attachment.content[x].creation
                                                                                                                                                              Definition

                                                                                                                                                              The date that the attachment was first created.

                                                                                                                                                              ShortThe time the attachment was created
                                                                                                                                                              Control0..1
                                                                                                                                                              TypedateTime
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                              Must Supporttrue
                                                                                                                                                              Obligations
                                                                                                                                                                ObligationsActor
                                                                                                                                                                SHALL:in-narrativeProducer of FHIR resources
                                                                                                                                                                Summarytrue
                                                                                                                                                                Requirements

                                                                                                                                                                This is often tracked as an integrity issue for use of the attachment.

                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                190. Communication.note
                                                                                                                                                                Definition

                                                                                                                                                                Additional notes or commentary about the communication by the sender, receiver or other interested parties.

                                                                                                                                                                ShortComments made about the communication
                                                                                                                                                                Control0..*
                                                                                                                                                                TypeAnnotation
                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                Summaryfalse
                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))