Scope and usage

​This profile is used as the Communication resource for the MedCom CareCommunication message. The MedComCareCommunication profile contains the main content of a message, which includes a communication identifier, at least one message segment with a message text (Danish: Meddelelsestekst) and a signature. The message may include zero or more message segments with an attachment and a signature. All message segments are found under the element Communication.payload. A more detailed description of the content of the MedComCareCommunication profile can be seen below.

The figure below shows the possible references from MedComCareCommunication profile, and thereby which resources that may be included in a CareCommunication message. A subject, in terms of a MedComCorePatient, shall always be included since a CareCommunication message always concerns a patient or citizen's matter. A MedComCorePractitionerRole and MedComCorePractitioner shall be included since these reference includes information about the author of the message text. A MedComCoreEncounter may be referenced if an episodeOfCare-identifier (Danish: forløbs-id) is relevant to include. Further, the MedComCorePractitionerRole or MedComCoreCareTeam may be included if a recipient or sender is added. Both profiles includes a reference to the MedComCoreOrganization the CareTeam or Practitioner is a part of.

Please refer to the tab "Snapshot Table(Must support)" below for the definition of the required content of a MedCom CareCommunication.

Communication identifier

The purpose of the communication identifier, in the element Communication.identifier.value, is to ensure a common identifier for a communication. This will help systems to connect incoming and outgoing CareCommuncations. This identifier must be a UUID v4 and it must remain the same when replying to a CareCommunication. The identifier must be updated when a CareCommunication is forwarded. This is elaborated in the Governance for CareCommunication.

Categories and topic

A CareCommunication shall have a category (Danish: Kategori), in the element Communication.category. The category describes the overall content of the communication and shall be selected from a nationally agreed list of categories defined in the ValueSet of category codes. Exactly one category code must be included in a CareCommunication. In time, new category codes may be relevant to include or existing codes may be irrelevant, why it should be expected that the ValueSet will change. Changes will be made in agreement with the business and will be warned.

In addition to the category, it is allowed to add a topic (Danish: Emne) in the element Communication.topic, to support and elaborate the category. This can either be inserted as free text or as regionally agreed codes, which is describes further in the clinical guidelines for application.

When sending a CareCommunication message with the category other, a topic shall be included. To ensure this, the invariant medcom-careCommunication-6 is created.

Priority

Priority, found in the element Communication.priority, is used to support the referral flow. It is only allowed to add a priority to a CareCommunication when the category of the message is regarding referral. In this case, priority can either be routine or asap. To ensure this, the invariant medcom-careCommunication-5 is created, which states that in no other case than when the category is regarding referral, a priority must be added. As described on clinical guidelines for application, the use of priority must follow the development in collective agreements and on basis of national requirements.

Message segments

A message segment consists of a message text including a signature or an attachment. The message text and attachment will both be included in the element Communication.payload. There are different requirements for the two types of message segments, which is documented in the following. At least one payload which includes the message text shall be included when sending a new CareCommunication message, but zero or more attachments may be included.

Note: Snippets from a patient's journal may be included in the message text or as an attachment, for instance, as a pdf-document. In both cases, it is recommended that the sender clearly describes in the message text or attachment, who the original author of the journal is and when it was written in the message test or attachment. If the snippet is included as an attachment, the author information may both be included as written/copied text or structured information.

When a CareCommunication message is forwarded, more than two organizations will be involved in the communication. It is a requirement that all organizations participating in the communication are made visible to the user. This must be clearly indicated for each message segment, ensuring full transparency and traceability of the message flow across healthcare actors. This information may, for example, be included alongside the signature. Furthermore, it must be clearly indicated which attachments were sent by which organization, and which message text they were sent with. This is necessary to ensure a clear and coherent overview.

Signature and relevant information

Payload:string: The written content of the message is of the datatype string defined by HL7. Line breaks must be represented as \n in FHIR JSON and as in FHIR XML. The signature for the message text consists of author name, author role, relevant phone number, and sent timestamp as structured data elements. The identifier is included for technical purposes. See the table below for an overview of the requirements.
Payload:attachment: The allowed types of attachments can be found in the ValueSet of allowed mimetypes. Further, it is allowed to include a link to a website. In a message segment with an attachment, the title, identifier and timestamp must be included, whereas it is optional to include information about the author, relevant phone number and creation date as structured data. Supporting all attachment types is optional when sending; however, systems must be able to receive all attachment types. If forwarding is supported, the ability to send all attachment types is also required.

R = required and O = optional.

A description of the above mentioned information can be found here:
Author name: The name of the person responsible for writing the message text. The author shall be described using a MedComCorePractitioner profile.
Author role: The role (Danish: stillingsbetegnelse) of the person responsible for writing the message text. The author role shall be described using a MedComCorePractitionerRole profile. It is recommended to use a role from the defined list of roles in the element PractitionerRole.code.coding.code. Alternatively, a it is allowed to add a role in the element PractitionerRole.code.text.
Relevant phone number: A relevant phone number e.g. to the department from which the CareCommunication is sent. The phone number should be applied automatically. In case it is not possible to apply the phone number automatically, it shall be applied by the author.
Timestamp: Represents the real world event, where the user presses "send" to send the CareCommunication.
Identifier: An UUID version 4 with a reference to the organisation who assigned the identifier, which will be the same as the sender organisation of the message segment.
Title: The title of the attached file. This should be applied by the system. Note: it is not allowed for the system to automatically include the '.filetype' in the title.
Creation: The date and time for when the attachment is created.

Content of the message segments

Message text must always be included in a CareCommunication, which applies to creating a new message, replying, and forwarding. All previous message segments with message text must be included in a message when replying and all relevant message segments must be included in a message when forwarding a message.

Attachments must always be included the first time they are sent. When replying to a CareCommunication, the base64-encoded content in the element Communication.payload:attachment.content.data or the link in the element Communication.payload:attachment.content.url must not be included, to avoid sending the same content back and forth. Instead the identifier must always be included in a reply and it should be used to identify which attachment(s) or link(s) that must be displayed to the receiver. When forwarding a message, the base64-encoded content of the attachments must be included.

Episode of care identifier

In the element Communication.encounter it is possible to reference a MedComCoreEncounter. An encounter describes the meeting between a patient and one or more healthcare providers or actors involved in the patient care. The Encounter resource contains an episodeOfCare-identifier. When receiving a message, either CareCommunication or EDIFACT/OIOXML message, there will in many cases be an episodeOfCare-identifier, as it described the id of the contact. If this is the case, the episodeOfCare-identifier shall always be included in the response. Altenatively, when a user at a hospital is in the context of e.g. an admission, the episodeOfCare-identifier should be coupled to a CareCommunication. Click here to get more information about the episodeOfCare-identifier

Recipient and sender

In the MedComCareCommunicationMessageHeader profile it is required to include information about a sender and receiver in terms of a reference to a MedComMessagingOrganization. This information is primarily used for transportation matters and will always include an EAN-number and SOR-identifier for each organization.

When sending a CareCommunication message it is possible to add a more specific receiver of the message, called a recipient, and a more specific sender, which can be found in the elements Communication.recipient and Communication.extension.sender, respectively. It is allowed to reference a MedComCoreCareTeam, which is people or an organization participating a coordination or delivery of patientcare, or MedComCorePractitionerRole, which references a MedComCorePractitioner to address a healthcare professional involved in patient care. Common for both MedComCoreCareTeam and MedComCorePractitionerRole/MedComCorePractitioner is that a name of the careteam or practitioner should be included as well as a reference to a MedComCoreOrganization which represents the sender or receiver defined in MedComCareCommunicationMessageHeader.

When receiving a CareCommunication that includes a specific sender (Communication.extension.sender), it is required that this specific sender is transferred to the reply as the specific recipient (Communication.recipient). This ensures continuity and clarity in the communication flow between involved parties.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: medcom-careCommunication-5, medcom-careCommunication-6, medcom-careCommunication-7, medcom-careCommunication-8, medcom-careCommunication-9, medcom-careCommunication-15
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	0..1	Narrative	The 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. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:sender	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-sender-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣC	1..1	Identifier	The communication identifier Constraints: medcom-uuidv4
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SOΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication. Required Pattern: unknown Obligations Actor SHALL:in-narrative Producer of FHIR resources
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
coding	SΣ	0..*	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
priority	SOΣ	0..1	code	Shall 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 Binding: MedComCareCommunicationRequestPriorityCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SOΣ	1..1	Reference(MedComCorePatient) {b}	Focus of message Obligations Actor SHALL:in-narrative Producer of FHIR resources
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element. Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
text	SOΣ	1..1	string	Plain text representation of the concept Obligations Actor SHALL:in-narrative Producer of FHIR resources
encounter	SOΣ	0..1	Reference(MedComCoreEncounter) {b}	Shall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recipient	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes 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. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included. Slice: Unordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date		0..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension
extension:author		0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension
extension:authorContact		0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension
extension:identifier		0..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
payload:string	S	1..*	BackboneElement	Message payload
Slices for extension		4..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	1..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	1..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	SO	1..1	string	Line breaks must be represented as in FHIR JSON and as 
 in FHIR XML. Obligations Actor SHALL:in-narrative Producer of FHIR resources
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain a link or content attached to the message.
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	S	1..1	Attachment	Message part content
contentType	SOΣ	0..1	code	The content type shall be present when the content is an attachment included in the data element. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png Obligations Actor SHALL:in-narrative Producer of FHIR resources
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content of the attachment.
url	SOΣ	0..1	url	Shall be present if the attachment is a link to a web page. Example General: http://www.acme.com/logo-small.png Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SOΣ	1..1	string	Note: it is not allowed for the system to automatically include '.filetype' in the title. Example General: Official Corporate Logo Obligations Actor SHALL:in-narrative Producer of FHIR resources
creation	SOΣ	0..1	dateTime	The time the attachment was created Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Communication.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Communication.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Communication.status	required	Pattern Value: unknown http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Communication.category	required	MedComCareCommunicationCategories http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories
Communication.priority	required	MedComCareCommunicationRequestPriority http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority
Communication.topic	example	CommunicationTopic http://hl7.org/fhir/ValueSet/communication-topic|4.0.1 From the FHIR Standard
Communication.payload:attachment.content[x].contentType	required	MedComCoreAttachmentMimeTypes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Communication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Communication	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Communication	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Communication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Communication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-careCommunication-5	error	Communication	Priority must not be present when Communication.category is other than 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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())
medcom-uuidv4	error	Communication.identifier	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}')
txt-1	error	Communication.text.div	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	error	Communication.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

This structure is derived from Communication

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: medcom-careCommunication-5, medcom-careCommunication-6, medcom-careCommunication-7, medcom-careCommunication-8, medcom-careCommunication-9, medcom-careCommunication-15
id	SO	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	0..1	Narrative	The 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.
status	S	1..1	code	generated | extensions | additional | empty
div	S	1..1	xhtml	Limited xhtml content
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:sender	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-sender-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
identifier	SC	1..1	Identifier	The communication identifier Constraints: medcom-uuidv4
value	S	1..1	string	The value that is unique
status	SO	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Required Pattern: unknown Obligations Actor SHALL:in-narrative Producer of FHIR resources
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
coding	S	0..*	Coding	Code defined by a terminology system
system	S	1..1	uri	Identity of the terminology system
code	SO	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
priority	SO	0..1	code	Shall 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 Binding: MedComCareCommunicationRequestPriorityCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SO	1..1	Reference(MedComCorePatient) {b}	Focus of message Obligations Actor SHALL:in-narrative Producer of FHIR resources
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element.
text	SO	1..1	string	Plain text representation of the concept Obligations Actor SHALL:in-narrative Producer of FHIR resources
encounter	SO	0..1	Reference(MedComCoreEncounter) {b}	Shall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recipient	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes 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. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included. Slice: Unordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date		0..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension
extension:author		0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension
extension:authorContact		0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension
extension:identifier		0..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
payload:string	S	1..*	BackboneElement	Message payload
extension		4..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	1..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	1..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
content[x]	SO	1..1	string	Line breaks must be represented as in FHIR JSON and as 
 in FHIR XML. Obligations Actor SHALL:in-narrative Producer of FHIR resources
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain a link or content attached to the message.
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
content[x]	S	1..1	Attachment	Message part content
contentType	SO	0..1	code	The content type shall be present when the content is an attachment included in the data element. Binding: MedComCoreAttachmentMimeTypes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content of the attachment.
url	SO	0..1	url	Shall be present if the attachment is a link to a web page. Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SO	1..1	string	Note: it is not allowed for the system to automatically include '.filetype' in the title. Obligations Actor SHALL:in-narrative Producer of FHIR resources
creation	SO	0..1	dateTime	The time the attachment was created Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Communication.category	required	MedComCareCommunicationCategories http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories
Communication.priority	required	MedComCareCommunicationRequestPriority http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority
Communication.payload:attachment.content[x].contentType	required	MedComCoreAttachmentMimeTypes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-careCommunication-5	error	Communication	Priority must not be present when Communication.category is other than 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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())
medcom-uuidv4	error	Communication.identifier	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}')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: medcom-careCommunication-5, medcom-careCommunication-6, medcom-careCommunication-7, medcom-careCommunication-8, medcom-careCommunication-9, medcom-careCommunication-15
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	0..1	Narrative	The 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. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:sender	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-sender-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣC	1..1	Identifier	The communication identifier Constraints: medcom-uuidv4
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(Resource)	Request fulfilled by this communication
partOf	Σ	0..*	Reference(Resource)	Part of this action
inResponseTo		0..*	Reference(Communication)	Reply to
status	?!SOΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication. Required Pattern: unknown Obligations Actor SHALL:in-narrative Producer of FHIR resources
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
priority	SOΣ	0..1	code	Shall 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 Binding: MedComCareCommunicationRequestPriorityCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
medium		0..*	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject	SOΣ	1..1	Reference(MedComCorePatient) {b}	Focus of message Obligations Actor SHALL:in-narrative Producer of FHIR resources
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element. Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
text	SOΣ	1..1	string	Plain text representation of the concept Obligations Actor SHALL:in-narrative Producer of FHIR resources
about		0..*	Reference(Resource)	Resources that pertain to this communication
encounter	SOΣ	0..1	Reference(MedComCoreEncounter) {b}	Shall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
sent		0..1	dateTime	When sent
received		0..1	dateTime	When received
recipient	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes 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. Obligations Actor SHALL:in-narrative Producer of FHIR resources
sender		0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why was communication done?
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included. Slice: Unordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date		0..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension
extension:author		0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension
extension:authorContact		0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension
extension:identifier		0..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
payload:string	S	1..*	BackboneElement	Message payload
id		0..1	string	Unique id for inter-element referencing
Slices for extension		4..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	1..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	1..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	SO	1..1	string	Line breaks must be represented as in FHIR JSON and as 
 in FHIR XML. Obligations Actor SHALL:in-narrative Producer of FHIR resources
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain a link or content attached to the message.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	S	1..1	Attachment	Message part content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SOΣ	0..1	code	The content type shall be present when the content is an attachment included in the data element. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png Obligations Actor SHALL:in-narrative Producer of FHIR resources
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content of the attachment.
url	SOΣ	0..1	url	Shall be present if the attachment is a link to a web page. Example General: http://www.acme.com/logo-small.png Obligations Actor SHALL:in-narrative Producer of FHIR resources
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SOΣ	1..1	string	Note: it is not allowed for the system to automatically include '.filetype' in the title. Example General: Official Corporate Logo Obligations Actor SHALL:in-narrative Producer of FHIR resources
creation	SOΣ	0..1	dateTime	The time the attachment was created Obligations Actor SHALL:in-narrative Producer of FHIR resources
note		0..*	Annotation	Comments made about the communication
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Communication.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Communication.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Communication.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Communication.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 From the FHIR Standard
Communication.status	required	Pattern Value: unknown http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Communication.statusReason	example	CommunicationNotDoneReason http://hl7.org/fhir/ValueSet/communication-not-done-reason|4.0.1 From the FHIR Standard
Communication.category	required	MedComCareCommunicationCategories http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories
Communication.priority	required	MedComCareCommunicationRequestPriority http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.topic	example	CommunicationTopic http://hl7.org/fhir/ValueSet/communication-topic|4.0.1 From the FHIR Standard
Communication.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1 From the FHIR Standard
Communication.payload:attachment.content[x].contentType	required	MedComCoreAttachmentMimeTypes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes
Communication.payload:attachment.content[x].language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Communication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Communication	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Communication	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Communication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Communication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-careCommunication-5	error	Communication	Priority must not be present when Communication.category is other than 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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())
medcom-uuidv4	error	Communication.identifier	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}')
txt-1	error	Communication.text.div	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	error	Communication.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: medcom-careCommunication-5, medcom-careCommunication-6, medcom-careCommunication-7, medcom-careCommunication-8, medcom-careCommunication-9, medcom-careCommunication-15
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	0..1	Narrative	The 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. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:sender	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-sender-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣC	1..1	Identifier	The communication identifier Constraints: medcom-uuidv4
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SOΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication. Required Pattern: unknown Obligations Actor SHALL:in-narrative Producer of FHIR resources
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
coding	SΣ	0..*	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
priority	SOΣ	0..1	code	Shall 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 Binding: MedComCareCommunicationRequestPriorityCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SOΣ	1..1	Reference(MedComCorePatient) {b}	Focus of message Obligations Actor SHALL:in-narrative Producer of FHIR resources
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element. Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
text	SOΣ	1..1	string	Plain text representation of the concept Obligations Actor SHALL:in-narrative Producer of FHIR resources
encounter	SOΣ	0..1	Reference(MedComCoreEncounter) {b}	Shall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recipient	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes 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. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included. Slice: Unordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date		0..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension
extension:author		0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension
extension:authorContact		0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension
extension:identifier		0..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
payload:string	S	1..*	BackboneElement	Message payload
Slices for extension		4..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	1..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	1..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	SO	1..1	string	Line breaks must be represented as in FHIR JSON and as 
 in FHIR XML. Obligations Actor SHALL:in-narrative Producer of FHIR resources
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain a link or content attached to the message.
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	S	1..1	Attachment	Message part content
contentType	SOΣ	0..1	code	The content type shall be present when the content is an attachment included in the data element. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png Obligations Actor SHALL:in-narrative Producer of FHIR resources
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content of the attachment.
url	SOΣ	0..1	url	Shall be present if the attachment is a link to a web page. Example General: http://www.acme.com/logo-small.png Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SOΣ	1..1	string	Note: it is not allowed for the system to automatically include '.filetype' in the title. Example General: Official Corporate Logo Obligations Actor SHALL:in-narrative Producer of FHIR resources
creation	SOΣ	0..1	dateTime	The time the attachment was created Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Communication.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Communication.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Communication.status	required	Pattern Value: unknown http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Communication.category	required	MedComCareCommunicationCategories http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories
Communication.priority	required	MedComCareCommunicationRequestPriority http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority
Communication.topic	example	CommunicationTopic http://hl7.org/fhir/ValueSet/communication-topic|4.0.1 From the FHIR Standard
Communication.payload:attachment.content[x].contentType	required	MedComCoreAttachmentMimeTypes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Communication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Communication	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Communication	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Communication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Communication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-careCommunication-5	error	Communication	Priority must not be present when Communication.category is other than 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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())
medcom-uuidv4	error	Communication.identifier	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}')
txt-1	error	Communication.text.div	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	error	Communication.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Differential View

This structure is derived from Communication

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: medcom-careCommunication-5, medcom-careCommunication-6, medcom-careCommunication-7, medcom-careCommunication-8, medcom-careCommunication-9, medcom-careCommunication-15
id	SO	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	0..1	Narrative	The 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.
status	S	1..1	code	generated | extensions | additional | empty
div	S	1..1	xhtml	Limited xhtml content
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:sender	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-sender-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
identifier	SC	1..1	Identifier	The communication identifier Constraints: medcom-uuidv4
value	S	1..1	string	The value that is unique
status	SO	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Required Pattern: unknown Obligations Actor SHALL:in-narrative Producer of FHIR resources
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
coding	S	0..*	Coding	Code defined by a terminology system
system	S	1..1	uri	Identity of the terminology system
code	SO	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
priority	SO	0..1	code	Shall 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 Binding: MedComCareCommunicationRequestPriorityCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SO	1..1	Reference(MedComCorePatient) {b}	Focus of message Obligations Actor SHALL:in-narrative Producer of FHIR resources
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element.
text	SO	1..1	string	Plain text representation of the concept Obligations Actor SHALL:in-narrative Producer of FHIR resources
encounter	SO	0..1	Reference(MedComCoreEncounter) {b}	Shall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
recipient	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes 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. Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included. Slice: Unordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date		0..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension
extension:author		0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension
extension:authorContact		0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension
extension:identifier		0..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
payload:string	S	1..*	BackboneElement	Message payload
extension		4..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	1..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	1..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
content[x]	SO	1..1	string	Line breaks must be represented as in FHIR JSON and as 
 in FHIR XML. Obligations Actor SHALL:in-narrative Producer of FHIR resources
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain a link or content attached to the message.
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
content[x]	S	1..1	Attachment	Message part content
contentType	SO	0..1	code	The content type shall be present when the content is an attachment included in the data element. Binding: MedComCoreAttachmentMimeTypes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content of the attachment.
url	SO	0..1	url	Shall be present if the attachment is a link to a web page. Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SO	1..1	string	Note: it is not allowed for the system to automatically include '.filetype' in the title. Obligations Actor SHALL:in-narrative Producer of FHIR resources
creation	SO	0..1	dateTime	The time the attachment was created Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Communication.category	required	MedComCareCommunicationCategories http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories
Communication.priority	required	MedComCareCommunicationRequestPriority http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority
Communication.payload:attachment.content[x].contentType	required	MedComCoreAttachmentMimeTypes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-careCommunication-5	error	Communication	Priority must not be present when Communication.category is other than 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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())
medcom-uuidv4	error	Communication.identifier	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}')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: medcom-careCommunication-5, medcom-careCommunication-6, medcom-careCommunication-7, medcom-careCommunication-8, medcom-careCommunication-9, medcom-careCommunication-15
id	SOΣ	0..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	0..1	Narrative	The 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. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:sender	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-sender-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣC	1..1	Identifier	The communication identifier Constraints: medcom-uuidv4
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(Resource)	Request fulfilled by this communication
partOf	Σ	0..*	Reference(Resource)	Part of this action
inResponseTo		0..*	Reference(Communication)	Reply to
status	?!SOΣ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication. Required Pattern: unknown Obligations Actor SHALL:in-narrative Producer of FHIR resources
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
priority	SOΣ	0..1	code	Shall 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 Binding: MedComCareCommunicationRequestPriorityCodes (required) Obligations Actor SHALL:in-narrative Producer of FHIR resources
medium		0..*	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject	SOΣ	1..1	Reference(MedComCorePatient) {b}	Focus of message Obligations Actor SHALL:in-narrative Producer of FHIR resources
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Topic must be added in the text-element. Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
text	SOΣ	1..1	string	Plain text representation of the concept Obligations Actor SHALL:in-narrative Producer of FHIR resources
about		0..*	Reference(Resource)	Resources that pertain to this communication
encounter	SOΣ	0..1	Reference(MedComCoreEncounter) {b}	Shall contain a reference to an Encounter resource with a episodeOfCare-identifier, if the identifier is included in a previous message. Obligations Actor SHALL:in-narrative Producer of FHIR resources
sent		0..1	dateTime	When sent
received		0..1	dateTime	When received
recipient	SO	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes 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. Obligations Actor SHALL:in-narrative Producer of FHIR resources
sender		0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why was communication done?
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a message text or an attachment. At least one payload with a message text shall be included. Slice: Unordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date		0..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension
extension:author		0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension
extension:authorContact		0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension
extension:identifier		0..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
payload:string	S	1..*	BackboneElement	Message payload
id		0..1	string	Unique id for inter-element referencing
Slices for extension		4..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	1..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	1..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	SO	1..1	string	Line breaks must be represented as in FHIR JSON and as 
 in FHIR XML. Obligations Actor SHALL:in-narrative Producer of FHIR resources
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain a link or content attached to the message.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:date	SO	1..1	dateTime	DateTimeExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:author	SO	0..1	Reference(MedComCorePractitionerRole) {b}	PractitionerExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:authorContact	SO	0..1	ContactPoint	ContactExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension Obligations Actor SHALL:in-narrative Producer of FHIR resources
extension:identifier	S	1..1	MedComAssignedIdentifier	IdentifierExtension URL: http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	S	1..1	Attachment	Message part content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SOΣ	0..1	code	The content type shall be present when the content is an attachment included in the data element. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png Obligations Actor SHALL:in-narrative Producer of FHIR resources
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content of the attachment.
url	SOΣ	0..1	url	Shall be present if the attachment is a link to a web page. Example General: http://www.acme.com/logo-small.png Obligations Actor SHALL:in-narrative Producer of FHIR resources
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SOΣ	1..1	string	Note: it is not allowed for the system to automatically include '.filetype' in the title. Example General: Official Corporate Logo Obligations Actor SHALL:in-narrative Producer of FHIR resources
creation	SOΣ	0..1	dateTime	The time the attachment was created Obligations Actor SHALL:in-narrative Producer of FHIR resources
note		0..*	Annotation	Comments made about the communication
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Communication.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Communication.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Communication.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Communication.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 From the FHIR Standard
Communication.status	required	Pattern Value: unknown http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Communication.statusReason	example	CommunicationNotDoneReason http://hl7.org/fhir/ValueSet/communication-not-done-reason|4.0.1 From the FHIR Standard
Communication.category	required	MedComCareCommunicationCategories http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-categories
Communication.priority	required	MedComCareCommunicationRequestPriority http://medcomfhir.dk/ig/terminology/ValueSet/medcom-careCommunication-requestPriority
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.topic	example	CommunicationTopic http://hl7.org/fhir/ValueSet/communication-topic|4.0.1 From the FHIR Standard
Communication.reasonCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1 From the FHIR Standard
Communication.payload:attachment.content[x].contentType	required	MedComCoreAttachmentMimeTypes http://medcomfhir.dk/ig/terminology/ValueSet/medcom-core-attachmentMimeTypes
Communication.payload:attachment.content[x].language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages|4.0.1 From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Communication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Communication	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Communication	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Communication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Communication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-careCommunication-5	error	Communication	Priority must not be present when Communication.category is other than 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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	error	Communication	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())
medcom-uuidv4	error	Communication.identifier	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}')
txt-1	error	Communication.text.div	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	error	Communication.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

This structure is derived from Communication

Summary

Mandatory: 10 elements(6 nested mandatory elements)
Must-Support: 35 elements

Structures

This structure refers to these other structures:

• MedComCorePatient (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-patient)
• MedComCoreEncounter (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-encounter)
• MedComCorePractitionerRole (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitionerrole)
• MedComCoreCareTeam (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-careteam)

Extensions

This structure refers to these extensions:

• http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-sender-extension
• http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-datetime-extension
• http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitioner-extension
• http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-contact-extension
• http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-identifier-extension

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Communication.payload