PCT GFE Composition - Patient Cost Transparency Implementation Guide v2.0.0-draft

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0-draft built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

Resource Profile: PCT GFE Composition

Official URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-composition		Version: 2.0.0-draft
Standards status: Trial-use	Maturity Level: 1	Computable Name: PCTGFEComposition
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.42.57

PCT GFE Composition that assembles the contents of a GFE (represented by one or more individual GFE Bundles) into a single logical package. This version fo the Bundle is a document type that will enable versioning, signing and being referenced by a DocumentReference for searching and subscription notifications.

Usages:

Use this Profile: PCT GFE Packet

Changes since version 1.1.0:

New Content

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
Composition	C	0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: pct-gfe-packet-composition-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:gfeServiceLinkingInfo	S	1..1	(Complex)	GFE Service Linking Information including planned period of service and a GFE linking identifier. Scheduled services SHALL have a plannedPeriodOfService valueDate or ValuePeriod URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
extension:requestOriginationType	S	1..1	CodeableConcept	Indicator as to whether the request for estimate originated from a scheduled or unscheduled service. URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestOriginationType Binding: PCT GFE Request Type Codes ValueSet (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Version-independent identifier for the Composition
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
status	?!Σ	1..1	code	preliminary \| final \| amended \| entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. 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://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
code		1..1	code	Symbol in syntax defined by the system Fixed Value: gfe-packet
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. 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://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
code		1..1	code	Symbol in syntax defined by the system Fixed Value: estimate
subject	SΣ	1..1	Reference(HRex Patient Demographics)	Who and/or what the composition is about
date	ΣC	1..1	dateTime	Composition editing time Constraints: pct-datetime-to-seconds
author	Σ	1..*	Reference(PCT Organization \| PCT Practitioner)	All involved authoring parties, including all Good Faith Estimate (GFE) providers
title	SΣ	1..1	string	Human Readable name/title
Slices for relatesTo	S	0..*	BackboneElement	Relationship to other GFE packets. Required if this estimate is replacing another. Slice: Unordered, Open by value:code
relatesTo:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces \| transforms \| signs \| appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
relatesTo:replaces	S	0..1	BackboneElement	The identifier of the document (Composition.identifier) this estimate replaces
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces \| transforms \| signs \| appends Binding: DocumentRelationshipType (required): The type of relationship between documents. Required Pattern: replaces
Slices for target[x]		1..1	Identifier	Target of the relationship Slice: Unordered, Closed by type:$this
target[x]:targetIdentifier	S	1..1	Identifier	Target of the relationship
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
Slices for section	C	1..*	BackboneElement	Sections Individual GFE Bundles Slice: Unordered, Open by value:code Constraints: cmp-1, cmp-2
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
section:gfeBundle	SC	1..*	BackboneElement	SHALL reference one PCTGFEBundle resource, which may be contained in the document bundle or may reference an external resource, and the associated author (GFE Contributor) contained in the document bundle. Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. 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://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentSection
code		1..1	code	Symbol in syntax defined by the system Fixed Value: gfe-section
author	S	1..1	Reference(PCT Practitioner \| PCT Organization) {b }	Associated GFE author (GFE Contributor) contained in the document bundle
entry	SC	1..1	Reference(PCT GFE Bundle) {b }	A reference to data that supports this section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.identifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Composition.status	required	CompositionStatus `http://hl7.org/fhir/ValueSet/composition-status\|4.0.1` From the FHIR Standard
Composition.type	preferred	Pattern Value: gfe-packet `http://hl7.org/fhir/ValueSet/doc-typecodes` From the FHIR Standard
Composition.category	example	Pattern Value: estimate `http://hl7.org/fhir/ValueSet/document-classcodes` From the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType `http://hl7.org/fhir/ValueSet/document-relationship-type\|4.0.1` From the FHIR Standard
Composition.relatesTo:replaces.code	required	Pattern Value: replaces `http://hl7.org/fhir/ValueSet/document-relationship-type\|4.0.1` From the FHIR Standard
Composition.relatesTo:replaces.target[x]:targetIdentifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Composition.section:gfeBundle.code	example	Pattern Value: gfe-section `http://hl7.org/fhir/ValueSet/doc-section-codes` From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:gfeBundle	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:gfeBundle	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	Composition	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	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	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()
pct-datetime-to-seconds	error	Composition.date	Datetime must be at least to seconds. : $this is dateTime implies $this.toString().length() >= 19
pct-gfe-packet-composition-1	error	Composition	Scheduled service requests require a planned period of service : extension.where(url='http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestOriginationType' and valueCodeableConcept.coding.where(code='scheduled-request').exists()).exists() implies extension.where(url='http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo' and extension.where(url = 'plannedPeriodOfService').exists()).exists()

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Composition	C	0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation Constraints: pct-gfe-packet-composition-1
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:gfeServiceLinkingInfo	S	1..1	(Complex)	GFE Service Linking Information including planned period of service and a GFE linking identifier. Scheduled services SHALL have a plannedPeriodOfService valueDate or ValuePeriod URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
extension:requestOriginationType	S	1..1	CodeableConcept	Indicator as to whether the request for estimate originated from a scheduled or unscheduled service. URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestOriginationType Binding: PCT GFE Request Type Codes ValueSet (required)
identifier		1..1	Identifier	Version-independent identifier for the Composition
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
type		1..1	CodeableConcept	Kind of composition (LOINC if possible) 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://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
code		1..1	code	Symbol in syntax defined by the system Fixed Value: gfe-packet
category		0..*	CodeableConcept	Categorization of Composition 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://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
code		1..1	code	Symbol in syntax defined by the system Fixed Value: estimate
subject	S	1..1	Reference(HRex Patient Demographics)	Who and/or what the composition is about
date	C	1..1	dateTime	Composition editing time Constraints: pct-datetime-to-seconds
author		1..*	Reference(PCT Organization \| PCT Practitioner)	All involved authoring parties, including all Good Faith Estimate (GFE) providers
title	S	1..1	string	Human Readable name/title
Slices for relatesTo	S	0..*	BackboneElement	Relationship to other GFE packets. Required if this estimate is replacing another. Slice: Unordered, Open by value:code
relatesTo:replaces	S	0..1	BackboneElement	The identifier of the document (Composition.identifier) this estimate replaces
code		1..1	code	replaces \| transforms \| signs \| appends Required Pattern: replaces
Slices for target[x]		1..1	Identifier	Target of the relationship Slice: Unordered, Open by type:$this
target[x]:targetIdentifier	S	1..1	Identifier	Target of the relationship
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
Slices for section		1..*	BackboneElement	Sections Individual GFE Bundles Slice: Unordered, Open by value:code
section:gfeBundle	S	1..*	BackboneElement	SHALL reference one PCTGFEBundle resource, which may be contained in the document bundle or may reference an external resource, and the associated author (GFE Contributor) contained in the document bundle.
code		1..1	CodeableConcept	Classification of section (recommended) 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://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentSection
code		1..1	code	Symbol in syntax defined by the system Fixed Value: gfe-section
author	S	1..1	Reference(PCT Practitioner \| PCT Organization) {b }	Associated GFE author (GFE Contributor) contained in the document bundle
entry	S	1..1	Reference(PCT GFE Bundle) {b }	A reference to data that supports this section
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
pct-datetime-to-seconds	error	Composition.date	Datetime must be at least to seconds. : $this is dateTime implies $this.toString().length() >= 19
pct-gfe-packet-composition-1	error	Composition	Scheduled service requests require a planned period of service : extension.where(url='http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestOriginationType' and valueCodeableConcept.coding.where(code='scheduled-request').exists()).exists() implies extension.where(url='http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo' and extension.where(url = 'plannedPeriodOfService').exists()).exists()