Generated Narrative: StructureDefinition Permission Last updated: 2021-01-02 08:58:31+1100 Name Flags Card. Type Description & Constraints Permission 0..* DomainResource Access Rules Elements defined in Ancestors:id, meta, implicitRules, language, <a href="http://hl7.org/fhir/R5/domainresource.html" title="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.">text, contained, <a href="http://hl7.org/fhir/R5/domainresource.html" title="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.">extension, <a href="http://hl7.org/fhir/R5/domainresource.html" title="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.#xA;#xA;Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).">modifierExtension #xD; identifier Σ 0..* Identifier Business Identifier for permission #xD; status Σ 1..1 code active | entered-in-error | draft | rejected Binding: PermissionStatusVS (required): Codes identifying the lifecycle stage of a product. #xD; asserter Σ 0..1 Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson | HealthcareService) The person or entity that asserts the permission #xD; date Σ 0..* dateTime The date that permission was asserted #xD; validity Σ 0..1 Period The period in which the permission is active #xD; justification Σ 0..1 BackboneElement The asserted justification for using the data #xD; basis Σ 0..* CodeableConcept The regulatory grounds upon which this Permission builds Binding: ConsentPolicyRuleCodes (example): Regulatory policy examples #xD; evidence Σ 0..* Reference(Resource) Justifing rational #xD; combining ?!Σ 1..1 code deny-overrides | permit-overrides | ordered-deny-overrides | ordered-permit-overrides | deny-unless-permit | permit-unless-deny Binding: PermissionRuleCombiningVS (required): How the rules are to be combined. #xD; rule ΣC 0..* BackboneElement Constraints to the Permission This repeating element order: The order of the rules processing is defined in rule combining selected in .combining element. #xD; import ΣC 0..1 Reference(Permission) Reference to a Permission #xD; type ?!ΣC 0..1 code deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied. #xD; data ΣC 0..* BackboneElement The selection criteria to identify data that is within scope of this provision #xD; resource Σ 0..* BackboneElement Explicit FHIR Resource references #xD; meaning Σ 1..1 code instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions. #xD; reference Σ 1..1 Reference(Resource) The actual data reference #xD; resourceType Σ 0..* Coding e.g. Resource Type, Profile, etc Binding: ResourceType (extensible): The resource types a consent provision covers. #xD; security Σ 0..* Coding Security tag code on .meta.security #xD; period Σ 0..1 Period Timeframe encompasing data create/update #xD; expression Σ 0..1 Expression Expression identifying the data #xD; activity ΣC 0..* BackboneElement A description or definition of which activities are allowed to be done on the data #xD; actor 0..* BackboneElement Who|what is controlled by this rule #xD; role 0..1 CodeableConcept How the actor is involved Binding: ParticipationRoleType (extensible): How an actor is involved in the rule. #xD; reference Σ 0..1 Reference(Device | Group | CareTeam | Organization | Patient | Practitioner | RelatedPerson | PractitionerRole | DeviceDefinition | HealthcareService) Authorized actor(s) #xD; action Σ 0..* CodeableConcept Actions controlled by this rule Binding: TypeRestfulInteraction (preferred): Detailed codes for the action. #xD; purpose Σ 0..* CodeableConcept The purpose for which the permission is given Binding: PurposeOfUse (3.1.0) (preferred): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels. #xD; limit 0..* BackboneElement What limits apply to the use of the data #xD; control Σ 0..* CodeableConcept What coded limits apply to the use of the data Binding: SecurityControlObservationValue (3.0.0) (preferred): Obligations and Refrains #xD; tag Σ 0..* Coding The sensitivity codes that must be removed from the data Binding: InformationSensitivityPolicy (3.0.0) (preferred): Sensitivity tags #xD; element Σ 0..* string What data elements that must be removed from the data #xD; Documentation for this format
Permission resource holds access rules for a given data and access request context.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
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.trace('id') in %resource.descendants().select(reference | as(uri))) or descendants().where(reference='#' | as(uri)='#').exists()).not()).trace('unmatched', id).empty()
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()
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
Entity. Role, or Act,Entity, Role, or Act
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Contained resources may be a resource type defined in the FHIR specification, or an [additional resource](http://build.fhir.org/resource.html#additional).
Extensions are always sliced by (at least) url
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://build.fhir.org/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
A unique identifier assigned to this permission.
Allows permission to be distinguished and referenced.
active | entered-in-error | draft | rejected
Codes identifying the lifecycle stage of a product.
The person or entity that asserts the permission
The person or entity that asserts the permission.
Consent.grantor, Consent.grantee, Consent.manager, Consent.controller
The period in which the permission is active
The period in which the permission is active.
The asserted justification for using the data
The asserted justification for using the data.
All FHIR elements must have a @value or children or both
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
The regulatory grounds upon which this Permission builds
This would be a codeableconcept, or a coding, for example, the 6 grounds for processing in GDPR.
While any resource may be used, DocumentReference, Consent, PlanDefinition, and Contract would be most frequent
deny-overrides | permit-overrides | ordered-deny-overrides | ordered-permit-overrides | deny-unless-permit | permit-unless-deny
Defines a procedure for arriving at an access decision given the set of rules.
see [XACML Combining Rules](http://docs.oasis-open.org/xacml/3.0/xacml-3.0-core-spec-cos01-en.html#_Toc325047267)
Defines how the rules are to be combined.
Each `.rule` is evaluated within the combining rule identified in the `.combining` element.
The order of the rules processing is defined in rule combining selected in .combining element.
If the import element is populated then the type, data, and activity shall not be populated
import.exists() implies type.exists().not() and data.exists().not() and activity.exists().not()
This rule is expressed in another Permission resource.
Sets the context for the meaning of the rules.
The selection criteria to identify data that is within scope of this provision
A description or definition of which activities are allowed to be done on the data.
Within a `.rule` any repetitions of the `.data` element are in an OR relationship. That is to say that the data identified by the rule is all the data identified by all repetitions of `.data`. Thus to identify one rule that applies to data tagged with `STD` and data that is tagged with `HIV`, one would repeat this at the `.data` level. Within the `.data` element, all elements and all repetitions of elements, are in an AND relationship. Thus to select data that has both `STD` and `HIV` one puts both into one `.rule`. To have different rules for `STD` from `HIV`, one would need to have two `.rule` elements. To have a rule that applies to both, those that have just `STD` and just `HIV`, this repetition may also be done at the data level as described above.
instance | related | dependents | authoredby
How the resource reference is interpreted when testing consent restrictions.
How a resource reference is interpreted when testing consent restrictions.
A reference to a specific resource that defines which resources are covered by this consent.
The resourceType(s) covered by this rule. The type can be a FHIR resource type or a profile on a type that indicates what information the rule applies to.
The intention of the resourceType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.
The resource types a consent provision covers.
The data in scope are those with the given codes present in that data .meta.security element.
Note the ConfidentialityCode vocabulary indicates the highest value, thus a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.
Timeframe encompasing data create/update
Clinical or Operational Relevant period of time that bounds the data controlled by this rule.
This has a different sense to the .validity.
Used when other data selection elements are insufficient.
Consent.provision.class, Consent.provision.code, Consent.provision.expression
A description or definition of which activities are allowed to be done on the data
Within a `.rule` any repetitions of the `.activity` element are in an OR relationship. That is to say that the rule applies to all the repetitions of `.activity`. Thus to identify one rule that applies to both `TREAT` and `HOPERAT`, one would have one rule with repetitions at the .activity level. Within the `.activity` element, all elements and all repetitions of elements, are in an AND relationship. Thus to control an actity that is covering purpose of both `TREAT` and `HOPERAT`, one rule with an `.activity` `.purpose` holding both `TREAT` and `HOPERAT` can define that rule. However this will not cover activities covering only `TREAT`, for that repeat at the `.activity` with just a `.purpose` of `TREAT`.
Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
When both reference and role are given the actor is only selected when that reference actor is functionally carrying out that role.
There is no specific actor associated with the rule
How the individual is involved in the activity that is described in the rule.
The actor(s) authorized for the defined activity.
Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.
The purpose for which the permission is given
The purpose for which the permission is given.
What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.
What limits apply to the use of the data
What restrictions must be applied to the use of the data by the actor.
Within a `.rule` all repetitions of the `.limit` all apply to the rule. That is to say if there are multiple limits, and the rule permits the activity, then all the identified limits are applied to that authorized activity.
There is no limit beyond those specified in the authorized activity to the authorized data.
What coded limits apply to the use of the data
One or more coded restriction such as a refrain or obligation.
The sensitivity codes that must be removed from the data
When this rule authorized data use, any data that is tagged with the code here must be redacted from the data provided for that authorized use.
What data elements that must be removed from the data
When this rule authorized data use, the data at the path indicated here, must be redacted from the authorized data provided for that authorized use.
The path identifies the element and is expressed as a `.` separated list of ancestor elements, beginning with the name of the resource or extension.