Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

## Resource Profile: Provider Attestation to Treatment Relationship

Official URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-treatment-relationship-consent | Version: 2.1.1
Standards status: Trial-use | Maturity Level: 2 | Computable Name: ProviderTreatmentAttestation
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

Enables a practitioner, facility, or organization to attest to a treatment relationship with a patient. This profile documents that a healthcare provider has an active treatment relationship with the patient for the purposes of care delivery, coordination, and related activities. This profile is used in the Provider-Member-Match operation to enable providers to assert treatment relationships with patients for bulk data access.

Usages:

- Use this Profile: Provider $multi-member-match Request
- Examples for this Profile: Consent/provider-treatment-attestation-1, Consent/treatment-attestation-ex1 and Consent/treatment-attestation-ex2

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Consent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | Status of the treatment relationship attestation Binding: Treatment Attestation Status (required)
scope | ?!S Σ | 1..1 | CodeableConcept | Treatment relationship scope Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: treatment
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category | S Σ | 1..* | CodeableConcept | Classification of consent (e.g., treatment relationship, attestation) Binding: ConsentCategoryCodes (extensible)
patient | S Σ | 1..1 | Reference(Patient) | Patient who is the subject of the treatment relationship
dateTime | S Σ | 1..1 | dateTime | Date/time when treatment relationship attestation was recorded
performer | S Σ | 1..* | Reference(Practitioner | Organization | PractitionerRole) | Practitioner, facility, or organization attesting to treatment relationship
organization | S Σ | 0..1 | Reference(Organization) | Organization responsible for the treatment relationship
source[x] | S Σ | 0..1 |  | Source of the attestation
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
policy | S | 0..* | BackboneElement | Policies or regulations governing the treatment relationship
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
verification | S Σ | 0..* | BackboneElement | Verification of the treatment relationship attestation
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
verified | S Σ | 1..1 | boolean | Whether the attestation has been verified
verifiedWith | S | 0..1 | Reference(Patient | RelatedPerson) | Who verified the attestation
verificationDate | S | 0..1 | dateTime | When the attestation was verified
provision | S Σ | 0..1 | BackboneElement | Details of the treatment relationship
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..1 | code | Whether this is a permission (permit) or denial Binding: Treatment Attestation Provision Type (required)
period | S Σ | 0..1 | Period | Time period for the treatment relationship
start | S Σ C | 0..1 | dateTime | Start date of treatment relationship
actor | S | 0..* | BackboneElement | Actors involved in the treatment relationship
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
role | S | 1..1 | CodeableConcept | How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference | S | 1..1 | Reference(Practitioner | Organization | PractitionerRole | CareTeam) | Resource for the actor (or group, by role)
purpose | S Σ | 0..* | Coding | Purpose of accessing patient information Binding: PurposeOfUse (extensible)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.status | Base | required | Treatment Attestation Status | 📦2.1.1 | This IG
Consent.scope | Base | extensible | Consent Scope Codes | 📍4.0.1 | FHIR Std.
Consent.category | Base | extensible | Consent Category Codes | 📦4.0.1 | FHIR Std.
Consent.provision.type | Base | required | Treatment Attestation Provision Type | 📦2.1.1 | This IG
Consent.provision.actor.​role | Base | extensible | SecurityRoleType | 📍4.0.1 | FHIR Std.
Consent.provision.purpose | Base | extensible | PurposeOfUse | 📦3.1.0 | THO v6.3

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Consent | 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 | Consent | 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 | Consent | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Consent | 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()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`
ppc-3 | error | Consent | IF Scope=research, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`
ppc-4 | error | Consent | IF Scope=adr, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`

This structure is derived from Consent

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent |  |  | Consent |
status | S | 1..1 | code | Status of the treatment relationship attestation Binding: Treatment Attestation Status (required)
scope | S | 1..1 | CodeableConcept | Treatment relationship scope Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: treatment
category | S | 1..* | CodeableConcept | Classification of consent (e.g., treatment relationship, attestation) Binding: ConsentCategoryCodes (extensible)
patient | S | 1..1 | Reference(Patient) | Patient who is the subject of the treatment relationship
dateTime | S | 1..1 | dateTime | Date/time when treatment relationship attestation was recorded
performer | S | 1..* | Reference(Practitioner | Organization | PractitionerRole) | Practitioner, facility, or organization attesting to treatment relationship
organization | S | 0..1 | Reference(Organization) | Organization responsible for the treatment relationship
source[x] | S | 0..1 | Attachment, Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) | Source of the attestation
policy | S | 0..* | BackboneElement | Policies or regulations governing the treatment relationship
verification | S | 0..* | BackboneElement | Verification of the treatment relationship attestation
verified | S | 1..1 | boolean | Whether the attestation has been verified
verifiedWith | S | 0..1 | Reference(Patient | RelatedPerson) | Who verified the attestation
verificationDate | S | 0..1 | dateTime | When the attestation was verified
provision | S | 0..1 | BackboneElement | Details of the treatment relationship
type | S | 0..1 | code | Whether this is a permission (permit) or denial Binding: Treatment Attestation Provision Type (required)
period | S | 0..1 | Period | Time period for the treatment relationship
start | S | 0..1 | dateTime | Start date of treatment relationship
actor | S | 0..* | BackboneElement | Actors involved in the treatment relationship
role | S | 1..1 | CodeableConcept | How the actor is involved
reference | S | 1..1 | Reference(Practitioner | Organization | PractitionerRole | CareTeam) | Resource for the actor (or group, by role)
purpose | S | 0..* | Coding | Purpose of accessing patient information Binding: PurposeOfUse (extensible)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Consent.status | Base | required | Treatment Attestation Status | 📦2.1.1 | This IG
Consent.category | Base | extensible | Consent Category Codes | 📦4.0.1 | FHIR Std.
Consent.provision.type | Base | required | Treatment Attestation Provision Type | 📦2.1.1 | This IG
Consent.provision.purpose | Base | extensible | PurposeOfUse | 📦3.1.0 | THO v6.3

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Consent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Identifier for this record (external references) Example General: {"system":"http://acme.org/identifier/local/eCMS","value":"Local eCMS identifier"}
status | ?!S Σ | 1..1 | code | Status of the treatment relationship attestation Binding: Treatment Attestation Status (required)
scope | ?!S Σ | 1..1 | CodeableConcept | Treatment relationship scope Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: treatment
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category | S Σ | 1..* | CodeableConcept | Classification of consent (e.g., treatment relationship, attestation) Binding: ConsentCategoryCodes (extensible)
patient | S Σ | 1..1 | Reference(Patient) | Patient who is the subject of the treatment relationship
dateTime | S Σ | 1..1 | dateTime | Date/time when treatment relationship attestation was recorded
performer | S Σ | 1..* | Reference(Practitioner | Organization | PractitionerRole) | Practitioner, facility, or organization attesting to treatment relationship
organization | S Σ | 0..1 | Reference(Organization) | Organization responsible for the treatment relationship
source[x] | S Σ | 0..1 |  | Source of the attestation
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
policy | S | 0..* | BackboneElement | Policies or regulations governing the treatment relationship
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
authority | C | 0..1 | uri | Enforcement source for policy
uri | C | 0..1 | uri | Specific policy covered by this consent
policyRule | Σ C | 0..1 | CodeableConcept | Regulation that this consents to Binding: ConsentPolicyRuleCodes (extensible): Regulatory policy examples.
verification | S Σ | 0..* | BackboneElement | Verification of the treatment relationship attestation
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
verified | S Σ | 1..1 | boolean | Whether the attestation has been verified
verifiedWith | S | 0..1 | Reference(Patient | RelatedPerson) | Who verified the attestation
verificationDate | S | 0..1 | dateTime | When the attestation was verified
provision | S Σ | 0..1 | BackboneElement | Details of the treatment relationship
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
type | S Σ | 0..1 | code | Whether this is a permission (permit) or denial Binding: Treatment Attestation Provision Type (required)
period | S Σ | 0..1 | Period | Time period for the treatment relationship
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ C | 0..1 | dateTime | Start date of treatment relationship
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
actor | S | 0..* | BackboneElement | Actors involved in the treatment relationship
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
role | S | 1..1 | CodeableConcept | How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference | S | 1..1 | Reference(Practitioner | Organization | PractitionerRole | CareTeam) | Resource for the actor (or group, by role)
action | Σ | 0..* | CodeableConcept | Actions controlled by this rule Binding: ConsentActionCodes (example): Detailed codes for the consent action.
securityLabel | Σ | 0..* | Coding | Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose | S Σ | 0..* | Coding | Purpose of accessing patient information Binding: PurposeOfUse (extensible)
class | Σ | 0..* | Coding | e.g. Resource Type, Profile, CDA, etc. Binding: ConsentContentClass (extensible): The class (type) of information a consent rule covers.
code | Σ | 0..* | CodeableConcept | e.g. LOINC or SNOMED CT code, etc. in the content Binding: ConsentContentCodes (example): If this code is found in an instance, then the exception applies.
dataPeriod | Σ | 0..1 | Period | Timeframe for data controlled by this rule
data | Σ | 0..* | BackboneElement | Data controlled by this rule
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
meaning | Σ | 1..1 | code | instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions.
reference | Σ | 1..1 | Reference(Resource) | The actual data reference
provision |  | 0..* | See provision (Consent) | Nested Exception Rules
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Consent.status | Base | required | Treatment Attestation Status | 📦2.1.1 | This IG
Consent.scope | Base | extensible | Consent Scope Codes | 📍4.0.1 | FHIR Std.
Consent.category | Base | extensible | Consent Category Codes | 📦4.0.1 | FHIR Std.
Consent.policyRule | Base | extensible | Consent PolicyRule Codes | 📍4.0.1 | FHIR Std.
Consent.provision.type | Base | required | Treatment Attestation Provision Type | 📦2.1.1 | This IG
Consent.provision.actor.​role | Base | extensible | SecurityRoleType | 📍4.0.1 | FHIR Std.
Consent.provision.action | Base | example | Consent Action Codes | 📍4.0.1 | FHIR Std.
Consent.provision.securityLabel | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
Consent.provision.purpose | Base | extensible | PurposeOfUse | 📦3.1.0 | THO v6.3
Consent.provision.class | Base | extensible | Consent Content Class | 📍4.0.1 | FHIR Std.
Consent.provision.code | Base | example | Consent Content Codes | 📍4.0.1 | FHIR Std.
Consent.provision.data.​meaning | Base | required | ConsentDataMeaning | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Consent | 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 | Consent | 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 | Consent | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Consent | 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()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`
ppc-3 | error | Consent | IF Scope=research, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`
ppc-4 | error | Consent | IF Scope=adr, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`

This structure is derived from Consent

Summary

Mandatory: 3 elements
Must-Support: 21 elements

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Consent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | Status of the treatment relationship attestation Binding: Treatment Attestation Status (required)
scope | ?!S Σ | 1..1 | CodeableConcept | Treatment relationship scope Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: treatment
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category | S Σ | 1..* | CodeableConcept | Classification of consent (e.g., treatment relationship, attestation) Binding: ConsentCategoryCodes (extensible)
patient | S Σ | 1..1 | Reference(Patient) | Patient who is the subject of the treatment relationship
dateTime | S Σ | 1..1 | dateTime | Date/time when treatment relationship attestation was recorded
performer | S Σ | 1..* | Reference(Practitioner | Organization | PractitionerRole) | Practitioner, facility, or organization attesting to treatment relationship
organization | S Σ | 0..1 | Reference(Organization) | Organization responsible for the treatment relationship
source[x] | S Σ | 0..1 |  | Source of the attestation
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
policy | S | 0..* | BackboneElement | Policies or regulations governing the treatment relationship
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
verification | S Σ | 0..* | BackboneElement | Verification of the treatment relationship attestation
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
verified | S Σ | 1..1 | boolean | Whether the attestation has been verified
verifiedWith | S | 0..1 | Reference(Patient | RelatedPerson) | Who verified the attestation
verificationDate | S | 0..1 | dateTime | When the attestation was verified
provision | S Σ | 0..1 | BackboneElement | Details of the treatment relationship
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..1 | code | Whether this is a permission (permit) or denial Binding: Treatment Attestation Provision Type (required)
period | S Σ | 0..1 | Period | Time period for the treatment relationship
start | S Σ C | 0..1 | dateTime | Start date of treatment relationship
actor | S | 0..* | BackboneElement | Actors involved in the treatment relationship
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
role | S | 1..1 | CodeableConcept | How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference | S | 1..1 | Reference(Practitioner | Organization | PractitionerRole | CareTeam) | Resource for the actor (or group, by role)
purpose | S Σ | 0..* | Coding | Purpose of accessing patient information Binding: PurposeOfUse (extensible)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.status | Base | required | Treatment Attestation Status | 📦2.1.1 | This IG
Consent.scope | Base | extensible | Consent Scope Codes | 📍4.0.1 | FHIR Std.
Consent.category | Base | extensible | Consent Category Codes | 📦4.0.1 | FHIR Std.
Consent.provision.type | Base | required | Treatment Attestation Provision Type | 📦2.1.1 | This IG
Consent.provision.actor.​role | Base | extensible | SecurityRoleType | 📍4.0.1 | FHIR Std.
Consent.provision.purpose | Base | extensible | PurposeOfUse | 📦3.1.0 | THO v6.3

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Consent | 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 | Consent | 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 | Consent | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Consent | 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()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`
ppc-3 | error | Consent | IF Scope=research, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`
ppc-4 | error | Consent | IF Scope=adr, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`

Differential View

This structure is derived from Consent

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent |  |  | Consent |
status | S | 1..1 | code | Status of the treatment relationship attestation Binding: Treatment Attestation Status (required)
scope | S | 1..1 | CodeableConcept | Treatment relationship scope Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: treatment
category | S | 1..* | CodeableConcept | Classification of consent (e.g., treatment relationship, attestation) Binding: ConsentCategoryCodes (extensible)
patient | S | 1..1 | Reference(Patient) | Patient who is the subject of the treatment relationship
dateTime | S | 1..1 | dateTime | Date/time when treatment relationship attestation was recorded
performer | S | 1..* | Reference(Practitioner | Organization | PractitionerRole) | Practitioner, facility, or organization attesting to treatment relationship
organization | S | 0..1 | Reference(Organization) | Organization responsible for the treatment relationship
source[x] | S | 0..1 | Attachment, Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) | Source of the attestation
policy | S | 0..* | BackboneElement | Policies or regulations governing the treatment relationship
verification | S | 0..* | BackboneElement | Verification of the treatment relationship attestation
verified | S | 1..1 | boolean | Whether the attestation has been verified
verifiedWith | S | 0..1 | Reference(Patient | RelatedPerson) | Who verified the attestation
verificationDate | S | 0..1 | dateTime | When the attestation was verified
provision | S | 0..1 | BackboneElement | Details of the treatment relationship
type | S | 0..1 | code | Whether this is a permission (permit) or denial Binding: Treatment Attestation Provision Type (required)
period | S | 0..1 | Period | Time period for the treatment relationship
start | S | 0..1 | dateTime | Start date of treatment relationship
actor | S | 0..* | BackboneElement | Actors involved in the treatment relationship
role | S | 1..1 | CodeableConcept | How the actor is involved
reference | S | 1..1 | Reference(Practitioner | Organization | PractitionerRole | CareTeam) | Resource for the actor (or group, by role)
purpose | S | 0..* | Coding | Purpose of accessing patient information Binding: PurposeOfUse (extensible)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Consent.status | Base | required | Treatment Attestation Status | 📦2.1.1 | This IG
Consent.category | Base | extensible | Consent Category Codes | 📦4.0.1 | FHIR Std.
Consent.provision.type | Base | required | Treatment Attestation Provision Type | 📦2.1.1 | This IG
Consent.provision.purpose | Base | extensible | PurposeOfUse | 📦3.1.0 | THO v6.3

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Consent | C | 0..* | Consent | A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Identifier for this record (external references) Example General: {"system":"http://acme.org/identifier/local/eCMS","value":"Local eCMS identifier"}
status | ?!S Σ | 1..1 | code | Status of the treatment relationship attestation Binding: Treatment Attestation Status (required)
scope | ?!S Σ | 1..1 | CodeableConcept | Treatment relationship scope Binding: ConsentScopeCodes (extensible): The four anticipated uses for the Consent Resource. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentscope
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: treatment
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
category | S Σ | 1..* | CodeableConcept | Classification of consent (e.g., treatment relationship, attestation) Binding: ConsentCategoryCodes (extensible)
patient | S Σ | 1..1 | Reference(Patient) | Patient who is the subject of the treatment relationship
dateTime | S Σ | 1..1 | dateTime | Date/time when treatment relationship attestation was recorded
performer | S Σ | 1..* | Reference(Practitioner | Organization | PractitionerRole) | Practitioner, facility, or organization attesting to treatment relationship
organization | S Σ | 0..1 | Reference(Organization) | Organization responsible for the treatment relationship
source[x] | S Σ | 0..1 |  | Source of the attestation
sourceAttachment |  |  | Attachment |
sourceReference |  |  | Reference(Consent | DocumentReference | Contract | QuestionnaireResponse) |
policy | S | 0..* | BackboneElement | Policies or regulations governing the treatment relationship
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
authority | C | 0..1 | uri | Enforcement source for policy
uri | C | 0..1 | uri | Specific policy covered by this consent
policyRule | Σ C | 0..1 | CodeableConcept | Regulation that this consents to Binding: ConsentPolicyRuleCodes (extensible): Regulatory policy examples.
verification | S Σ | 0..* | BackboneElement | Verification of the treatment relationship attestation
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
verified | S Σ | 1..1 | boolean | Whether the attestation has been verified
verifiedWith | S | 0..1 | Reference(Patient | RelatedPerson) | Who verified the attestation
verificationDate | S | 0..1 | dateTime | When the attestation was verified
provision | S Σ | 0..1 | BackboneElement | Details of the treatment relationship
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
type | S Σ | 0..1 | code | Whether this is a permission (permit) or denial Binding: Treatment Attestation Provision Type (required)
period | S Σ | 0..1 | Period | Time period for the treatment relationship
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
start | S Σ C | 0..1 | dateTime | Start date of treatment relationship
end | Σ C | 0..1 | dateTime | End time with inclusive boundary, if not ongoing
actor | S | 0..* | BackboneElement | Actors involved in the treatment relationship
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
role | S | 1..1 | CodeableConcept | How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference | S | 1..1 | Reference(Practitioner | Organization | PractitionerRole | CareTeam) | Resource for the actor (or group, by role)
action | Σ | 0..* | CodeableConcept | Actions controlled by this rule Binding: ConsentActionCodes (example): Detailed codes for the consent action.
securityLabel | Σ | 0..* | Coding | Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose | S Σ | 0..* | Coding | Purpose of accessing patient information Binding: PurposeOfUse (extensible)
class | Σ | 0..* | Coding | e.g. Resource Type, Profile, CDA, etc. Binding: ConsentContentClass (extensible): The class (type) of information a consent rule covers.
code | Σ | 0..* | CodeableConcept | e.g. LOINC or SNOMED CT code, etc. in the content Binding: ConsentContentCodes (example): If this code is found in an instance, then the exception applies.
dataPeriod | Σ | 0..1 | Period | Timeframe for data controlled by this rule
data | Σ | 0..* | BackboneElement | Data controlled by this rule
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
meaning | Σ | 1..1 | code | instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions.
reference | Σ | 1..1 | Reference(Resource) | The actual data reference
provision |  | 0..* | See provision (Consent) | Nested Exception Rules
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Consent.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Consent.status | Base | required | Treatment Attestation Status | 📦2.1.1 | This IG
Consent.scope | Base | extensible | Consent Scope Codes | 📍4.0.1 | FHIR Std.
Consent.category | Base | extensible | Consent Category Codes | 📦4.0.1 | FHIR Std.
Consent.policyRule | Base | extensible | Consent PolicyRule Codes | 📍4.0.1 | FHIR Std.
Consent.provision.type | Base | required | Treatment Attestation Provision Type | 📦2.1.1 | This IG
Consent.provision.actor.​role | Base | extensible | SecurityRoleType | 📍4.0.1 | FHIR Std.
Consent.provision.action | Base | example | Consent Action Codes | 📍4.0.1 | FHIR Std.
Consent.provision.securityLabel | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
Consent.provision.purpose | Base | extensible | PurposeOfUse | 📦3.1.0 | THO v6.3
Consent.provision.class | Base | extensible | Consent Content Class | 📍4.0.1 | FHIR Std.
Consent.provision.code | Base | example | Consent Content Codes | 📍4.0.1 | FHIR Std.
Consent.provision.data.​meaning | Base | required | ConsentDataMeaning | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Consent | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Consent | 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 | Consent | 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 | Consent | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Consent | 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()`
ppc-1 | error | Consent | Either a Policy or PolicyRule | `policy.exists() or policyRule.exists()`
ppc-2 | error | Consent | IF Scope=privacy, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()`
ppc-3 | error | Consent | IF Scope=research, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='research').exists().not()`
ppc-4 | error | Consent | IF Scope=adr, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()`
ppc-5 | error | Consent | IF Scope=treatment, there must be a patient | `patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()`

This structure is derived from Consent

Summary

Mandatory: 3 elements
Must-Support: 21 elements

Maturity: 2

Other representations of profile: CSV, Excel, Schematron