Health Connect Australia Provider Directory FHIR Implementation Guide

Usage notes

This extension is used to convey whether the parent resource should be hidden from display in the Provider Directory. It carries coded information about the actor who initiated the suppression.

Datatype and context

The Suppressed extension is a complex extension that contains information about suppression behaviour. It includes a required suppressedBy sub-extension (CodeableConcept) that indicates who initiated the suppression request. The coded values are drawn from the HCPD Responsible Party Type CodeSystem, and the extension also includes an optional includeSelf sub-extension (boolean) for Organization-specific behaviour.

This extension is profiled on the following HCPD resources: Organization, Practitioner, PractitionerRole, HealthcareService, Location, and Endpoint.

• Being an optional cardinality, when absent the resource is visible in Provider Directory listings
• When present, it indicates the resource is suppressed and identifies who initiated the suppression
• For Organization resources, the Suppressed extension includes an includeSelf sub-extension that controls whether the Organization itself is suppressed in addition to cascade suppression of child resources

Suppression scenarios

This extension enables several suppression patterns:

1. Practitioner self-suppression:
   • Practitioner with Suppressed extension (practitioner-initiated) automatically hides themselves and cascades to suppress all their roles
2. Organization suppression with cascade control:
   • Organization with Suppressed extension (organisation-initiated) triggers cascade suppression to all child resources
   • The nested includeSelf sub-extension controls whether the Organization itself is also hidden:
     • When true: Organization hides itself and automatically cascades to suppress everything related (locations, services, etc.)
     • When false: Organization keeps itself visible but cascade automatically hides all related resources (locations, services, etc.)
3. PractitionerRole specific suppression:
   • PractitionerRole with Suppressed extension is hidden without affecting the Practitioner profile
   • Can be initiated by either practitioner-initiated or organisation-initiated codes

Processing and client obligations

• The default state of this extension, being optional, is that it is not present on a profile and that resource is visible.
• When present, the Suppressed extension indicates the resource should be suppressed from Provider Directory listings.
• For Organization profiles, the nested includeSelf sub-extension controls whether the Organization itself is suppressed in addition to cascade suppression of child resources.
• Suppressed resources remain stored in the internal Health Connect Provider Directory system but are excluded from the external IG and API responses.
• Downstream vendors no longer receive the resources in API payloads but must still handle the consequences of suppression (i.e., missing expected resources).
• Client requester actors of the bulk data export service will receive communication about suppressed identifiers via a List resource but not the suppressed resources themselves.
• Client requester actors SHALL be required to cleanse their local systems of suppressed resources using the related identifiers.

Hierarchical suppression model

The HCPD Provider Directory operates on a hierarchical model where certain resources are considered children of others. This hierarchy determines the cascading behaviour of suppression and which initiator codes are permitted on each resource type.

Suppression cascade:

• Organization (parent) → HealthcareService, Location, PractitionerRole, Endpoint (children)
  • When the Suppressed extension is present on an Organization, suppression automatically cascades to its child HealthcareService, Location, PractitionerRole, and Endpoint resources

The coded values in Suppressed indicate who has the authority to suppress a resource, with some resources having competing authorities due to their position in the hierarchy.

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

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..1	Extension(4.0.1)	Hide Resource in Directory
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:suppressedBy	S	1..1	Extension	Who initiated the suppression
extension		0..0		Extension
url		1..1	uri	"suppressedBy"
value[x]	S	1..1	CodeableConcept	Value of extension
coding		1..2	Coding	Code defined by a terminology system Binding: ResponsiblePartyType_VS (26.0.0) (required)
extension:includeSelf	S	0..1	Extension	Controls Organization self-suppression
extension		0..0		Extension
url		1..1	uri	"includeSelf"
value[x]	S	0..1	boolean	Value of extension
url		1..1	uri	"http://digitalhealth.gov.au/fhir/cc/StructureDefinition/suppressed"
value[x]		0..0		Value of extension
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..1	Extension(4.0.1)	Hide Resource in Directory Constraints: ext-1
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:suppressedBy	S	1..1	Extension	Who initiated the suppression Constraints: ext-1
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url Constraints: ext-1
url		1..1	uri	"suppressedBy"
value[x]	S	1..1	CodeableConcept	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
coding	Σ	1..2	Coding	Code defined by a terminology system Binding: ResponsiblePartyType_VS (26.0.0) (required)
text	Σ	0..1	string	Plain text representation of the concept
extension:includeSelf	S	0..1	Extension	Controls Organization self-suppression Constraints: ext-1
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url Constraints: ext-1
url		1..1	uri	"includeSelf"
value[x]	S	0..1	boolean	Value of extension
url		1..1	uri	"http://digitalhealth.gov.au/fhir/cc/StructureDefinition/suppressed"
Documentation for this format

Differential View

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..1	Extension(4.0.1)	Hide Resource in Directory
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:suppressedBy	S	1..1	Extension	Who initiated the suppression
extension		0..0		Extension
url		1..1	uri	"suppressedBy"
value[x]	S	1..1	CodeableConcept	Value of extension
coding		1..2	Coding	Code defined by a terminology system Binding: ResponsiblePartyType_VS (26.0.0) (required)
extension:includeSelf	S	0..1	Extension	Controls Organization self-suppression
extension		0..0		Extension
url		1..1	uri	"includeSelf"
value[x]	S	0..1	boolean	Value of extension
url		1..1	uri	"http://digitalhealth.gov.au/fhir/cc/StructureDefinition/suppressed"
value[x]		0..0		Value of extension
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..1	Extension(4.0.1)	Hide Resource in Directory Constraints: ext-1
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:suppressedBy	S	1..1	Extension	Who initiated the suppression Constraints: ext-1
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url Constraints: ext-1
url		1..1	uri	"suppressedBy"
value[x]	S	1..1	CodeableConcept	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
coding	Σ	1..2	Coding	Code defined by a terminology system Binding: ResponsiblePartyType_VS (26.0.0) (required)
text	Σ	0..1	string	Plain text representation of the concept
extension:includeSelf	S	0..1	Extension	Controls Organization self-suppression Constraints: ext-1
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url Constraints: ext-1
url		1..1	uri	"includeSelf"
value[x]	S	0..1	boolean	Value of extension
url		1..1	uri	"http://digitalhealth.gov.au/fhir/cc/StructureDefinition/suppressed"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Indicates whether the parent resource should be hidden from display in the Provider Directory. Contains coded information about the actor who initiated the suppression and optional control flags.

• suppressedBy: CodeableConcept: Identifies the actor who initiated the suppression request (e.g., practitioner, organisation).
• includeSelf: boolean: When true, this Organization and all child resources (HealthcareService, Location, PractitionerRole, Endpoint) are suppressed via cascade. When false, this Organization remains visible while child resources are suppressed via cascade. Only applies to Organization resources.