CA Baseline Practitioner Profile for Registries

This Practitioner profile sets minimum expectations for the Practitioner resource to record, search and fetch demographics and other administrative information about a person who is directly or indirectly involved in the provisioning of healthcare.

This profile further constrains the general purpose Practitioner profile and is intended to be used by Provider or Healthcare Directory systems.

Differences from US Core

Note: This profile was generated from HL7 StructureDefinition on 2020-02-19 and constrained during a review of US Core against Canadian sources.

Mandatory Data Elements

All elements or attributes defined in FHIR have cardinality as part of their definition - a minimum number of required appearances and a maximum number.

Most elements in FHIR specification have a minimum cardinality of 0, which means that they may be missing from a resource when it is exchanged between systems.

Required elements:

• a identifier
• a practitioner name

In addition to that, some optional elements (e.g., Practitioner.qualification) have required components that MUST be present if that optional element is provided.

Data Absent Reason

In situations where the minimum cardinality of an element or attribute is 1 and information is missing and the Responder knows the precise reason for the absence of data, Responders SHALL send the reason for the missing information using values (such as NullFlavor) from the value set where they exist or using the DataAbsentReason extension.

Must Support Data Elements

Some elements are labeled as MustSupport meaning that implementations that produce or consume resources SHALL provide “support” for the element in some meaningful way (see Must Support definition).

Following elements are marked as Must Support in the Practitioner profile to aid record matching in databases with many pediatric records.

Must Support elements:

• an identifier
• a practitioner name
• contact detail (e.g. a telephone number or an email address)
• a birth date

Extensions

Deceased Extension

This Practitioner profile contains optional deceased extension to indicate if a practitioner is deceased or not.

This extension was previously labeled as a modifier extension (because of its potential impacts on clinical processes if the practitioner is marked deceased), but was removed after further discussion on the nuances of making something a modifierExtension vs regular extension if it was expected to be picked up by registry implementation guides that collect deceased practitioner information but may or may not use it in ways that would align to HL7 FHIR R4 definition and expectations for modifierExtension.

Implementers should recognize that the determination of whether this should be considered a modifierExtension is ongoing. Since Modifier Extensions should have extreme caution in their application and are further nuanced by the use cases in the implementing registry systems, this extension has been shifted back to a regular extension to align to use in existing implementations. Implementers who are considering using this extension in their guidance might consider applying a Must Support flag on the extension, but those treating wanting to re-create it as a modifier extension are required to review the [FHIR Guidance on Modifier Extensions])(https://www.hl7.org/fhir/R4/extensibility.html#modifierExtension) before including this extension in their profile. Implementers should also be aware of the Practitioner.deceased[x] R5 concept and that the CA Baseline is monitoring changes in the element to determine if the approach to this extension requires a shift.

Usage Note

This Practitioner profile is intended to provide a foundation for a central or distributed Provider or Healthcare Directory. Additional work flow components and elements may be required for a particular implementation.

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

This structure is derived from PractitionerProfile

Name	Flags	Card.	Type	Description & Constraints
Practitioner		0..*	PractitionerProfile	Practitioner Profile
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
deceased		0..1	boolean, date	Indicates if the individual is deceased or not. URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
identifier	S	1..*	IdentifierCABaseline	An identifier intended for computation
name	S	1..*	HumanName	The name(s) associated with the practitioner
telecom	S	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
address
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
preferred		0..1	boolean	HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
birthDate	S	0..1	date	The date on which the practitioner was born
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:All Slices				Content/Rules for all slices
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
coding:Registry		0..*	Coding	Code defined by a terminology system
system		1..1	uri	QualifiedRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
coding:eReferral		0..*	Coding	Code defined by a terminology system
system		1..1	uri	HealthcareProviderRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Practitioner		0..*	PractitionerProfile	Practitioner Profile
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
deceased		0..1	boolean, date	Indicates if the individual is deceased or not. URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..*	IdentifierCABaseline	An identifier intended for computation
name	SΣC	1..*	HumanName	The name(s) associated with the practitioner ca-baseline-practitioner-name: Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
telecom	SΣ	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
birthDate	SΣ	0..1	date	The date on which the practitioner was born
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
coding:Registry	Σ	0..*	Coding	Code defined by a terminology system
system	Σ	1..1	uri	QualifiedRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
coding:eReferral	Σ	0..*	Coding	Code defined by a terminology system
system	Σ	1..1	uri	HealthcareProviderRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Practitioner.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
Practitioner.qualification.code	example	v2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7) http://terminology.hl7.org/ValueSet/v2-2.7-0360 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-practitioner-name	error	Practitioner.name	Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
dom-2	error	Practitioner	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Practitioner	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	Practitioner	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	Practitioner	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Practitioner	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()

Name	Flags	Card.	Type	Description & Constraints
Practitioner		0..*	PractitionerProfile	Practitioner Profile
id	Σ	0..1	id	Logical id of this artifact
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		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
deceased		0..1	boolean, date	Indicates if the individual is deceased or not. URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..*	IdentifierCABaseline	An identifier intended for computation
active	Σ	0..1	boolean	Whether this practitioner's record is in active use
name	SΣC	1..*	HumanName	The name(s) associated with the practitioner ca-baseline-practitioner-name: Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
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 | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	Σ	0..1	string	Text representation of the full name
family	ΣC	0..1	string	Family name (often called 'Surname')
given	ΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	SΣ	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
address	Σ	0..*	Address	Address(es) of the practitioner that are not role specific (typically home address)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
preferred		0..1	boolean	HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type	Σ	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text	Σ	0..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	Σ	0..*	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	Σ	0..1	string	Name of city, town etc. Example General: Erewhon
district	Σ	0..1	string	District name (aka county) Example General: Madison
state	Σ	0..1	string	Sub-unit of country (abbreviations ok)
postalCode	Σ	0..1	string	Postal code for area Example General: 9132
country	Σ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
period	Σ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender	Σ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	SΣ	0..1	date	The date on which the practitioner was born
photo		0..*	Attachment	Image of the person
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier		0..*	Identifier	An identifier for this qualification for the practitioner
code		1..1	CodeableConcept	Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:All Slices				Content/Rules for all slices
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	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:Registry	Σ	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	Σ	1..1	uri	QualifiedRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:eReferral	Σ	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	Σ	1..1	uri	HealthcareProviderRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
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
period		0..1	Period	Period during which the qualification is valid
issuer		0..1	Reference(Organization)	Organization that regulates and issues the qualification
communication		0..*	CodeableConcept	A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Practitioner.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Practitioner.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
Practitioner.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 from the FHIR Standard
Practitioner.address.type	required	AddressType http://hl7.org/fhir/ValueSet/address-type|4.0.1 from the FHIR Standard
Practitioner.gender	required	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 from the FHIR Standard
Practitioner.qualification.code	example	v2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7) http://terminology.hl7.org/ValueSet/v2-2.7-0360 from the FHIR Standard
Practitioner.communication	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-practitioner-name	error	Practitioner.name	Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
dom-2	error	Practitioner	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Practitioner	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	Practitioner	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	Practitioner	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Practitioner	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()

Differential View

This structure is derived from PractitionerProfile

Name	Flags	Card.	Type	Description & Constraints
Practitioner		0..*	PractitionerProfile	Practitioner Profile
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
deceased		0..1	boolean, date	Indicates if the individual is deceased or not. URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
identifier	S	1..*	IdentifierCABaseline	An identifier intended for computation
name	S	1..*	HumanName	The name(s) associated with the practitioner
telecom	S	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
address
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
preferred		0..1	boolean	HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
birthDate	S	0..1	date	The date on which the practitioner was born
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
code
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:All Slices				Content/Rules for all slices
system		1..1	uri	Identity of the terminology system
code		1..1	code	Symbol in syntax defined by the system
coding:Registry		0..*	Coding	Code defined by a terminology system
system		1..1	uri	QualifiedRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
coding:eReferral		0..*	Coding	Code defined by a terminology system
system		1..1	uri	HealthcareProviderRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Practitioner		0..*	PractitionerProfile	Practitioner Profile
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
deceased		0..1	boolean, date	Indicates if the individual is deceased or not. URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..*	IdentifierCABaseline	An identifier intended for computation
name	SΣC	1..*	HumanName	The name(s) associated with the practitioner ca-baseline-practitioner-name: Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
use	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
telecom	SΣ	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
birthDate	SΣ	0..1	date	The date on which the practitioner was born
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:All Slices				Content/Rules for all slices
system	Σ	1..1	uri	Identity of the terminology system
code	Σ	1..1	code	Symbol in syntax defined by the system
coding:Registry	Σ	0..*	Coding	Code defined by a terminology system
system	Σ	1..1	uri	QualifiedRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
coding:eReferral	Σ	0..*	Coding	Code defined by a terminology system
system	Σ	1..1	uri	HealthcareProviderRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Practitioner.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
Practitioner.qualification.code	example	v2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7) http://terminology.hl7.org/ValueSet/v2-2.7-0360 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-practitioner-name	error	Practitioner.name	Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
dom-2	error	Practitioner	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Practitioner	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	Practitioner	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	Practitioner	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Practitioner	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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Practitioner		0..*	PractitionerProfile	Practitioner Profile
id	Σ	0..1	id	Logical id of this artifact
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		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
deceased		0..1	boolean, date	Indicates if the individual is deceased or not. URL: http://hl7.org/fhir/ca/baseline/StructureDefinition/ext-deceased
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	1..*	IdentifierCABaseline	An identifier intended for computation
active	Σ	0..1	boolean	Whether this practitioner's record is in active use
name	SΣC	1..*	HumanName	The name(s) associated with the practitioner ca-baseline-practitioner-name: Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present
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 | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	Σ	0..1	string	Text representation of the full name
family	ΣC	0..1	string	Family name (often called 'Surname')
given	ΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use
telecom	SΣ	0..*	ContactPoint	A contact detail for the practitioner (that apply to all roles)
address	Σ	0..*	Address	Address(es) of the practitioner that are not role specific (typically home address)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
preferred		0..1	boolean	HL7 Preferred Address Flag extension URL: http://hl7.org/fhir/StructureDefinition/iso21090-preferred
use	?!Σ	0..1	code	home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
type	Σ	0..1	code	postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both
text	Σ	0..1	string	Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132
line	Σ	0..*	string	Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street
city	Σ	0..1	string	Name of city, town etc. Example General: Erewhon
district	Σ	0..1	string	District name (aka county) Example General: Madison
state	Σ	0..1	string	Sub-unit of country (abbreviations ok)
postalCode	Σ	0..1	string	Postal code for area Example General: 9132
country	Σ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
period	Σ	0..1	Period	Time period when address was/is in use Example General: {"start":"2010-03-23","end":"2010-07-01"}
gender	Σ	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
birthDate	SΣ	0..1	date	The date on which the practitioner was born
photo		0..*	Attachment	Image of the person
qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier		0..*	Identifier	An identifier for this qualification for the practitioner
code		1..1	CodeableConcept	Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:All Slices				Content/Rules for all slices
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	Σ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:Registry	Σ	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	Σ	1..1	uri	QualifiedRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scpqual
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:eReferral	Σ	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	Σ	1..1	uri	HealthcareProviderRoleType Fixed Value: https://fhir.infoway-inforoute.ca/CodeSystem/scptype
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
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
period		0..1	Period	Period during which the qualification is valid
issuer		0..1	Reference(Organization)	Organization that regulates and issues the qualification
communication		0..*	CodeableConcept	A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Practitioner.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Practitioner.name.use	required	NameUse http://hl7.org/fhir/ValueSet/name-use|4.0.1 from the FHIR Standard
Practitioner.address.use	required	AddressUse http://hl7.org/fhir/ValueSet/address-use|4.0.1 from the FHIR Standard
Practitioner.address.type	required	AddressType http://hl7.org/fhir/ValueSet/address-type|4.0.1 from the FHIR Standard
Practitioner.gender	required	AdministrativeGender http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1 from the FHIR Standard
Practitioner.qualification.code	example	v2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7) http://terminology.hl7.org/ValueSet/v2-2.7-0360 from the FHIR Standard
Practitioner.communication	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ca-baseline-practitioner-name	error	Practitioner.name	Either name.given and/or name.family SHALL be present or a Data Absent Reason Extension SHALL be present : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
dom-2	error	Practitioner	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Practitioner	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	Practitioner	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	Practitioner	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Practitioner	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()

This structure is derived from PractitionerProfile

Identifiers

Multiple types of provider identifiers may be used in Practitioner.identifier element in the Canadian context:

• Provincial health plan provider/ Billing number
• Licence Number
• Medical Doctor Number

Implementers may use other identifiers to capture in a more specific way such as internal provider number, jurisdictions providing credentials. The full list of possible identifier types is in Canadian URI Registry

In some cases, the same license number can be used as the provider identifier and provider’s qualification identifier.

Telecom

A provider may have multiple ways to be contacted with different uses or applicable periods. This Practitioner profile allows multiple contact points (e.g. a telephone number or an email address) by which the individual may be contacted.

To indicate the preferred way to contact use Practitioner.telecom.rank attribute (i.e., the ContactPoint.rank component) that specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Address

The Practitioner profile is provided for use in a Canadian context where some constraint on content is desirable to guarantee the quality of the Canadian address whilst still supporting other type of address (e.g., other countries or UNstructured addresses).

Canadian postal code

If an address in the Practitioner resource instance represents Canadian address, it SHOULD follow Canadian postal code format.

The Canadian Postal Code SHOULD be a six-character uniformly structured uppercase alphanumeric code in the form of “ANA NAN”, where “A” represents an alphabetic character and “N” represents a numeric character, with one space between the first three and the last three characters.

A hyphen SHOULD NOT be used (example of UNacceptable format: T0L-1K0).

Preferred

The Practitioner.address MAY have a Preferred extension. This is the FHIR standard defined extension used as a flag denoting whether parent address item is preferred.

Qualifications & Credentials

In Canadian context qualifications and credentials are not synonymous. This difference is defined by slices applied to Practitioner.qualification.code.coding element.

Qualification defines a code for the degree or educational rank that the credential specifies and may also apply to an expertise type. This profile recommends to use Canadian QualifiedRoleType value set as the coded representation of the provider’s qualification.

Credential defines a role type that is used to categorize an entity that delivers health care in an expected and professional manner to an entity in need of health care services. It uses Canadian HealthcareProviderRoleType value set as the coded representation of the provider’s credentials.

The binding strength for the Practitioner.qualification.code element is Preferred meaning that implementers are encouraged to draw codes from the specified code system for interoperability purposes but are not required to do so to be considered conformant.

Example:

"code": {
  "coding": [
    {
      "system": "https://fhir.infoway-inforoute.ca/CodeSystem/scpqual",
      "code": "BSC",
      "display": "Bachelor of Science Degree"
    }
  ],
  "text": "Bachelor of Science Degree"
}