Common Components FHIR Implementation Guide

Usage Notes

This extension is used to indicate whether the parent resource should be hidden from display. 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, and an optional includeSelf sub-extension (boolean) for Organization-specific behaviour. The coded values are drawn from the Common Components Responsible Party Type CodeSystem.

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

• When absent, the resource is visible in 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

• By default (when the extension is absent), resources are visible.
• When present, the Suppressed extension indicates the resource should be suppressed.
• Suppressed resources remain stored in the internal system but are excluded from 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 Common Components IG supports 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.extension		1..*	Extension	Extension
Extension.Slices for extension				Content/Rules for all slices
Extension.Slices for extension.extension:suppressedBy		1..1	Extension	Who initiated the suppression
Extension.Slices for extension.extension:suppressedBy.extension		0..0		Extension
Extension.Slices for extension.extension:suppressedBy.url		1..1	uri	"suppressedBy"
Extension.Slices for extension.extension:suppressedBy.value[x]		1..1	CodeableConcept	Value of extension
Extension.Slices for extension.extension:suppressedBy.value[x].coding		1..2	Coding	Code defined by a terminology system Binding: ResponsiblePartyType_VS (26.0.0) (required)
Extension.Slices for extension.extension:includeSelf		0..1	Extension	Controls Organization self-suppression
Extension.Slices for extension.extension:includeSelf.extension		0..0		Extension
Extension.Slices for extension.extension:includeSelf.url		1..1	uri	"includeSelf"
Extension.Slices for extension.extension:includeSelf.value[x]		0..1	boolean	Value of extension
Extension.url		1..1	uri	"http://digitalhealth.gov.au/fhir/cc/StructureDefinition/suppressed"
Extension.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
Extension.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:suppressedBy		1..1	Extension	Who initiated the suppression Constraints: ext-1
Extension.Slices for extension.extension:suppressedBy.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:suppressedBy.extension		0..0		Extension Slice: Unordered, Open by value:url Constraints: ext-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:suppressedBy.url		1..1	uri	"suppressedBy"
Extension.Slices for extension.extension:suppressedBy.value[x]		1..1	CodeableConcept	Value of extension
Extension.Slices for extension.extension:suppressedBy.value[x].id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:suppressedBy.value[x].extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
Extension.Slices for extension.extension:suppressedBy.value[x].coding	Σ This element is included in summaries.	1..2	Coding	Code defined by a terminology system Binding: ResponsiblePartyType_VS (26.0.0) (required)
Extension.Slices for extension.extension:suppressedBy.value[x].text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Extension.Slices for extension.extension:includeSelf		0..1	Extension	Controls Organization self-suppression Constraints: ext-1
Extension.Slices for extension.extension:includeSelf.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:includeSelf.extension		0..0		Extension Slice: Unordered, Open by value:url Constraints: ext-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:includeSelf.url		1..1	uri	"includeSelf"
Extension.Slices for extension.extension:includeSelf.value[x]		0..1	boolean	Value of extension
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.extension		1..*	Extension	Extension
Extension.Slices for extension				Content/Rules for all slices
Extension.Slices for extension.extension:suppressedBy		1..1	Extension	Who initiated the suppression
Extension.Slices for extension.extension:suppressedBy.extension		0..0		Extension
Extension.Slices for extension.extension:suppressedBy.url		1..1	uri	"suppressedBy"
Extension.Slices for extension.extension:suppressedBy.value[x]		1..1	CodeableConcept	Value of extension
Extension.Slices for extension.extension:suppressedBy.value[x].coding		1..2	Coding	Code defined by a terminology system Binding: ResponsiblePartyType_VS (26.0.0) (required)
Extension.Slices for extension.extension:includeSelf		0..1	Extension	Controls Organization self-suppression
Extension.Slices for extension.extension:includeSelf.extension		0..0		Extension
Extension.Slices for extension.extension:includeSelf.url		1..1	uri	"includeSelf"
Extension.Slices for extension.extension:includeSelf.value[x]		0..1	boolean	Value of extension
Extension.url		1..1	uri	"http://digitalhealth.gov.au/fhir/cc/StructureDefinition/suppressed"
Extension.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
Extension.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url Constraints: ext-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:suppressedBy		1..1	Extension	Who initiated the suppression Constraints: ext-1
Extension.Slices for extension.extension:suppressedBy.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:suppressedBy.extension		0..0		Extension Slice: Unordered, Open by value:url Constraints: ext-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:suppressedBy.url		1..1	uri	"suppressedBy"
Extension.Slices for extension.extension:suppressedBy.value[x]		1..1	CodeableConcept	Value of extension
Extension.Slices for extension.extension:suppressedBy.value[x].id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:suppressedBy.value[x].extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
Extension.Slices for extension.extension:suppressedBy.value[x].coding	Σ This element is included in summaries.	1..2	Coding	Code defined by a terminology system Binding: ResponsiblePartyType_VS (26.0.0) (required)
Extension.Slices for extension.extension:suppressedBy.value[x].text	Σ This element is included in summaries.	0..1	string	Plain text representation of the concept
Extension.Slices for extension.extension:includeSelf		0..1	Extension	Controls Organization self-suppression Constraints: ext-1
Extension.Slices for extension.extension:includeSelf.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:includeSelf.extension		0..0		Extension Slice: Unordered, Open by value:url Constraints: ext-1 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:includeSelf.url		1..1	uri	"includeSelf"
Extension.Slices for extension.extension:includeSelf.value[x]		0..1	boolean	Value of extension
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.