Name Flags Card. Type Description & Constraints Contract 0..* Contract Legal Agreement Slices for extension 0..* Extension Extension Slice: Unordered, Open by type:url resource-pertainsToGoal S 0..* Reference(Goal) The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal instantiatesCanonical 0..1 Reference(Contract_eltss) Source Contract Definition domain 0..* Reference(Location_eltss) A sphere of control governed by an authoritative jurisdiction, organization, or person site 0..* Reference(Location_eltss) Specific Location author 0..1 Reference(Patient_eltss | Practitioner_eltss | eLTSS PractitionerRole Profile | US Core Organization Profile) Source of Contract contentDefinition publisher 0..1 Reference(Practitioner_eltss | eLTSS PractitionerRole Profile | US Core Organization Profile) Publisher Entity term 0..* BackboneElement Contract Term List offer 1..1 BackboneElement Context of the Contract term party 0..* BackboneElement Offer Recipient reference 1..* Reference(Patient_eltss | Practitioner_eltss | eLTSS PractitionerRole Profile | Group | US Core Organization Profile) Referenced entity asset valuedItem responsible 0..1 Reference(Patient_eltss | Practitioner_eltss | eLTSS PractitionerRole Profile | eLTSS RelatedPerson Profile | US Core Organization Profile) Who will make payment recipient 0..1 Reference(Patient_eltss | Practitioner_eltss | eLTSS PractitionerRole Profile | eLTSS RelatedPerson Profile | US Core Organization Profile) Who will receive payment action subject 0..* BackboneElement Entity of the action reference 1..* Reference(Patient_eltss | Practitioner_eltss | eLTSS PractitionerRole Profile | Group | US Core Organization Profile) Entity of the action context 0..1 Reference(EpisodeOfCare_eltss | US Core Encounter Profile) Episode associated with action requester 0..* Reference(Patient_eltss | Practitioner_eltss | eLTSS PractitionerRole Profile | Group | US Core Organization Profile) Who asked for action performer 0..1 Reference(Patient_eltss | Practitioner_eltss | eLTSS PractitionerRole Profile | US Core Organization Profile) Actor that wil execute (or not) the action reasonReference 0..* Reference(Condition_eltss | Observation_eltss | Questionnaire_eltss | US Core DocumentReference Profile | DiagnosticReport | QuestionnaireResponse) Why is action (not) needed? signer S 0..* BackboneElement Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature type S 1..1 Coding Contract Signatory Role party S 1..1 Reference(Patient_eltss | Practitioner_eltss | eLTSS PractitionerRole Profile | eLTSS RelatedPerson Profile | US Core Organization Profile) Person, Guardian / Legal Representative, Support Planner, or Service Provider Printed Name signature S 1..* Signature Contract Documentation Signature type S 1..* Coding Indication of the reason the entity signed the object(s) when S 1..1 instant Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature Date who S 1..1 Reference(eLTSS PractitionerRole Profile | eLTSS RelatedPerson Profile | US Core Organization Profile | Practitioner_eltss | Patient_eltss) Person, Guardian/Legal Representative, Support Planner, or Service Provider Printed Name data S 0..1 base64Binary The actual signature content (XML DigSig. JWS, picture, etc.) rule 0..* BackboneElement Computable Contract Language content[x] 1..1 Attachment, Reference(DocumentReference) Computable Contract Rule(s) Documentation for this format
HL7 International / Human and Social Services
A legally enforceable, formally recorded unilateral or bilateral directive (i.e., a policy or agreement).
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
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
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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 it's 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 it's 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 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, and nor can they have their own independent transaction scope.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources.
Indicates that the resource is related to either the measurement, achievement or progress towards the referenced goal. For example, a Procedure to exercise pertainsToGoal of losing weight.
This extension is limited to subject-specific activity-related resources (events & intents). I.e. This can't be put on Goal or Patient. This association isn't for the purpose of goal management, but for things such as noting that a particular observation result, prescription or other activity is pertinent to the achievement (or possibly non-achievement) of the referenced goal.
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 manageable, 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).
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.
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://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Unique identifier for this Contract or a derivative that references a Source Contract.
This is the business identifier of the contract content conveyed. It may be a derivative of the legally binding contract, in which case, the identifier of the basal contract is contained in the Contract.binding referenced Contract.
Canonical identifier for this contract, represented as a URI (globally unique).
Used in a domain that uses a supplied contract repository.
An absolute URI that is used to identify this contract when it is referenced in a specification, model, design, instance or a contract derivative; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which this plan definition is (or will be) published.
An edition identifier used for business purposes to label business significant variants.
Note - This is a business versionId, not a resource version id (see discussion http://build.fhir.org/resource.html#versions) Comments - There may be different contract instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the plan definition with the format [url]|[version].
The identifier that is used to identify this version of the contract when it is referenced in a specification, model, design, instance, or contract derivative. This is an arbitrary value managed by the contract author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.
amended | appended | cancelled | disputed | entered-in-error | executable | executed | negotiable | offered | policy | rejected | renewed | revoked | resolved | terminated
This element is labeled as a modifier because the status contains codes that mark the contract as not currently valid or active.
This is the Contract Business Workflow Status.
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
A code specifying the state of the resource instance.
Legal states of the formation of a legal instrument, which is a formally executed written document that can be formally attributed to its author, records and formally expresses a legally enforceable act, process, or contractual duty, obligation, or right, and therefore evidences that act, process, or agreement.
The legal state of a contract follows a prescribed flow as defined by the legal community and these state may be indepenedent of the workflow state.
Detailed codes for the legal state of a contract.
The URL pointing to a FHIR-defined Contract Definition that is adhered to in whole or part by this Contract.
The URL pointing to an externally maintained definition that is adhered to in whole or in part by this Contract.
Content derived from the basal information
The minimal content derived from the basal information source at a specific stage in its lifecycle.
In the context of a contract, the information source of the content derivative shall be the information referenced by the contract.binding. The Contract Resource may function simply as the computable representation of the executed contract, which may be the attached to the Contract Resource as the “binding” or as the “friendly” electronic form. For example, a Contract Resource may be automatically populated with the values expressed in a related QuestionnaireResponse. However, the Contract Resource may be considered the legally binding contract if it is the only “executed” form of this contract, and includes the signatures as *The Contract Resource may function as the computable representation of an application or offer in a pre-executed Contract if the grantor has not entered any values. In this case, it is populated with values in a “legal” form of the application or offer or by the values in an associated Questionnaire. If the grantor has filled in the legal form or the associated Questionnaire Response, then these values are used to populate a pre-executed Contract Resource. If the Contract.topic is considered an application or offer, then the policy is often required to be attached as the “legal” basis for the application to ensure “informed consent” to the contract, and that any discrepancy between the application and the policy are interpreted against the policy. Implementers should check organizational and jurisdictional policies to determine the relationship among multiple representations of a contract pre- and post-execution.
This is an example set of Content Derivative type codes, which represent the minimal content derived from the basal information source.
Maps partially to several v3 codes: ActClass: REG (registration) Description: Represents the act of maintaining information about the registration of its associated registered subject. The subject can be either an Act or a Role, and includes subjects such as lab exam definitions, drug protocol definitions, prescriptions, persons, patients, practitioners, and equipment. The registration may have a unique identifier - separate from the unique identification of the subject - as well as a core set of related participations and act relationships that characterize the registration event and aid in the disposition of the subject information by a receiving system. Observation: VERIF (Verification) Description: An act which describes the process whereby a 'verifying party' validates either the existence of the Role attested to by some Credential or the actual Vetting act and its details. TRFR (transfer) Description: The act of transferring information without the intent of imparting understanding about a topic to the subject that is the recipient or holder of the transferred information where the participation association must be RCV or HLD. _ActDetectedIssueManagementCode [abstract term] Description: Codes dealing with the management of Detected Issue observations. _ActInformationAccessContextCode [abstract term] Description: Concepts conveying the context in which authorization given under jurisdictional law, by organizational policy, or by a patient consent directive permits the collection, access, use or disclosure of specified patient health information. _ActListCode [abstract term]vDescription: Provides codes associated with ActClass value of LIST (working list). RefusalReasonCode [abstract term] Description: Description: Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.
The Contract issuance dateTime often precedes the Contract effective dateTime.
Act.availabilityTime. Definition: A time expression specifying when an Observation, Procedure, or other Act occurs, or, depending on the mood, is supposed to occur, scheduled to occur, etc. The activityTime includes the times of component actions (such as preparation and clean-up). For Procedures and SubstanceAdministrations, the activityTime can provide a needed administrative function by providing a more inclusive time to be anticipated in scheduling. UsageNotes:The activityTime is primarily of administrative rather than clinical use. The clinically relevant time is the effectiveTime. When an observation of a prior symptom is made, the activityTime describes the time the observation is made, as opposed to effectiveTime which is the time the symptom is reported to have occurred. Thus the activityTime may be entirely different from the effectiveTime of the same Act. However, even apart from clinical use cases, designers should first consider effectiveTime as the primary relevant time for an Act. ActivityTime indicates when an Act occurs, not when it is recorded.
Relevant time or time-period when this Contract is applicable.
The dateTime upon which the Contract is binding.
Act.effectiveTime Definition: The clinically or operationally relevant time of an act, exclusive of administrative activity.
Event resulting in discontinuation or termination of this Contract instance by one or more parties to the contract.
The target entity impacted by or of interest to parties to the agreement.
The Contract.subject is an entity that has some role with respect to the Contract.topic and Contract.topic.term, which is of focal interest to the parties to the contract and likely impacted in a significant way by the Contract.action/Contract.action.reason and the Contract.term.action/Contract.action.reason. In many cases, the Contract.subject is a Contract.signer if the subject is an adult; has a legal interest in the contract; and incompetent to participate in the contract agreement.
Authority under which this Contract has standing
A formally or informally recognized grouping of people, principals, organizations, or jurisdictions formed for the purpose of achieving some form of collective action such as the promulgation, administration and enforcement of contracts and policies.
The governance framework responsible for ensuring compliance with or enforcement of the contract or policy.
Organization Role. CONCEPT DOMAIN: OrganizationEntityType Description: Further classifies entities of EntityClass ORG.
A sphere of control governed by an authoritative jurisdiction, organization, or person
Recognized governance framework or system operating with a circumscribed scope in accordance with specified principles, policies, processes or procedures for managing rights, actions, or behaviors of parties or principals relative to resources.
The entities bound by governance to comply with the enforcement of contracts or policies by a recognized authority.
TERR (territory of authority) Description: Relates a place entity (player) as the region over which the scoper (typically an Organization) has certain authority (jurisdiction). For example, the Calgary Regional Health Authority (scoper) has authority over the territory "Region 4 of Alberta" (player) in matters of health. Entity Class = Place? A physical place or site with its containing structure. May be natural or man-made. The geographic position of a place might or might not be constant. CONCEPT DOMAIN: TerritoryEntityType Description: A territorial entity that may be cited as the body over which an agency exercises jurisdiction, or which defines a sphere in which a party has a particular responsibility. CONCEPT DOMAIN: OrganizationEntityType Description: Further classifies entities of EntityClass ORG.
Sites in which the contract is complied with, exercised, or in force.
A natural language name identifying this Contract definition, derivative, or instance in any legal state. Provides additional information about its content. This name should be usable as an identifier for the module by machine processing applications such as code generation.
The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
Support human navigation and code generation.
A short, descriptive, user-friendly title for this Contract definition, derivative, or instance in any legal state.t giving additional information about its content.
An explanatory or alternate user-friendly title for this Contract definition, derivative, or instance in any legal state.t giving additional information about its content.
Alternative representation of the title for this Contract definition, derivative, or instance in any legal state., e.g., a domain specific contract number related to legislation.
The individual or organization that authored the Contract definition, derivative, or instance in any legal state.
A selector of legal concerns for this Contract definition, derivative, or instance in any legal state.
Narrows the range of legal concerns to focus on the achievement of specific contractual objectives.
Requirement: May be used to focus the topic of a Contract definition, derivative, or instance in any legal state. Comment: Contractual areas of concern are very broad. This element supports narrowing the area of concern to more specific term topics within this Contract. Given the wide range of contract topics, implementers need to be cognizant of the business use case for which they are designing a FHIR Contract, and narrowly specify the topic being represented with respect to the Contract.type and any specializing Contract.subtype. The same topic, e.g., an asset such as a good or service, such as a real property, medical supply, insurance, information, a procedure or employment, or a manner of conduct, such adherence to a privacy, trust, or security policy, may be the topic of multiple types of contracts. One way to determine the Contract.topic is to answer the question: “What is the overall objective of this legal instrument. The Contract.topic is described with more detail by the terms of the Contract.
A high-level category for the legal instrument, whether constructed as a Contract definition, derivative, or instance in any legal state. Provides additional information about its content within the context of the Contract's scope to distinguish the kinds of systems that would be interested in the contract.
Maps to multiple ActClass and ActCode Concept Domains and Code Systems such as the following: In the ActClass Concept Domain: ActClassPolicy. In the ActCode Concept Domain: ActContractType, which generalizes ActFinancialContractType, ActCoverageType, ActBillingArrangementType. ActConsentType, which generalizes ActDataConsentType; ActFinancialParticipationConsentType; ActInformationAccessCode; AdvanceBeneficiaryNoticeType. ActPolicyType, which generalizes: ActPrivacyPolicyType, ActSensitivityPrivacyPolicyType, ActSecurityPolicyType. In the ActClass Code System: CNTRCT (contract) Description: An agreement of obligation between two or more parties that is subject to contractual law and enforcement, lwhich generalizes FCNTRCT (financial contract) and COV (coverage). POLICY (policy) - Description: A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by one party on: The activity of another party; the behavior of another party; or the manner in which an act is executed. LEAF CONCEPTS: JURISPOL (jurisdictional policy) Description:A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by a jurisdiction on: The activity of another party; the behavior of another party; or the manner in which an act is executed.Examples:A jurisdictional mandate regarding the prescribing and dispensing of a particular medication. A jurisdictional privacy or security regulation dictating the manner in which personal health information is disclosed. A jurisdictional requirement that certain services or health conditions are reported to a monitoring program, e.g., immunizations, methadone treatment, or cancer registries.ORGPOL (organizational policy)Examples:A clinical or research protocols imposed by a payer, a malpractice insurer, or an institution to which a provider must adhere. A mandate imposed by a denominational institution for a provider to provide or withhold certain information from the patient about treatment options.SCOPOL (scope of practice policy)Description:An ethical or clinical obligation, requirement, rule, or expectation imposed or strongly encouraged by organizations that oversee particular clinical domains or provider certification which define the boundaries within which a provider may practice and which may have legal basis or ramifications.Examples:An ethical obligation for a provider to fully inform a patient about all treatment options. An ethical obligation for a provider not to disclose personal health information that meets certain criteria, e.g., where disclosure might result in harm to the patient or another person. The set of health care services which a provider is credentialed or privileged to provide. STDPOL (standard of practice policy) Examples:A payer may require a prescribing provider to adhere to formulary guidelines. An institution may adopt clinical guidelines and protocols and implement these within its electronic health record and decision support systems. CONS (consent)Description: The Consent class represents informed consents and all similar medico-legal transactions between the patient (or his legal guardian) and the provider. Examples are informed consent for surgical procedures, informed consent for clinical trials, advanced beneficiary notice, against medical advice decline from service, release of information agreement, etc. The details of consents vary. Often an institution has a number of different consent forms for various purposes, including reminding the physician about the topics to mention. Such forms also include patient education material. In electronic medical record communication, consents thus are information-generating acts on their own and need to be managed similar to medical activities. Thus, Consent is modeled as a special class of Act. The "signatures" to the consent document are represented electronically through Participation instances to the consent object. Typically an informed consent has Participation.typeCode of "performer", the healthcare provider informing the patient, and "consenter", the patient or legal guardian. Some consent may associate a witness or a notary public (e.g., living wills, advanced directives). In consents where a healthcare provider is not required (e.g. living will), the performer may be the patient himself or a notary public.
Sub-category for the Contract that distinguishes the kinds of systems that would be interested in the Contract within the context of the Contract's scope.
Examples of Contract or Policy subtypes in ActCodes:_ActCoverageTypeCode Definition: Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties. Generalizes: _ActInsurancePolicyCode; _ActInsuranceTypeCode; ActProgramTypeCode. _ActPolicyType Description:Types of policies that further specify the ActClassPolicy value set. Generalizes: _ActPrivacyPolicy; _ActPrivacyLaw; _InformationSensitivityPolicy; ActTrustPolicyType; SecurityPolicy. _ActInvoiceAdjudicationPaymentGroupCode Description: Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc., e.g. RECOV (recovery) Description: Retroactive adjustment such as fee rate adjustment due to contract negotiations.
Precusory content developed with a focus and intent of supporting the formation a Contract instance, which may be associated with and transformable into a Contract.
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Additional content defined by implementations
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 manageable, 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 manageable, 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
Precusory content structure and use, i.e., a boilerplate, template, application for a contract such as an insurance policy or benefits under a program, e.g., workers compensation.
Detailed codes for the definition of contracts.
Detailed codes for the additional definition of contracts.
The individual or organization that published the Contract precursor content.
The date (and optionally time) when the contract was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the contract changes.
amended | appended | cancelled | disputed | entered-in-error | executable | executed | negotiable | offered | policy | rejected | renewed | revoked | resolved | terminated.
Status of the publication of contract content.
A copyright statement relating to Contract precursor content. Copyright statements are generally legal restrictions on the use and publishing of the Contract precursor content.
One or more Contract Provisions which may be related and conveyed as a group and may contain nested groups.
RIM mechanism for grouping or nesting rules, which are likely Acts and Observations.
Unique identifier for this particular Contract Provision.
When this Contract Provision was issued.
Relevant time or time-period when this Contract Provision is applicable.
A legal clause or condition contained within a contract that requires one or both parties to perform a particular requirement by some specified time or prevents one or both parties from performing a particular requirement by some specified time.
Detailed codes for the types of contract provisions.
Contract Term Type specific classification
A specialized legal clause or condition based on overarching contract type.
Detailed codes for the subtypes of contract provisions.
Statement of a provision in a policy or a contract.
Security labels that protect the handling of information about the term and its elements, which may be specifically identified..
Requirement - Within a Contract, a security label may apply to the one to many nested group of terms or to a term, whether inside a group or a singleton. This security label protects the term and its contained provision elements. The security label on the entire set of term provision elements may be different from the security labels on a contained offer, asset, valuedItem, or data such as sensitive information, and must be the high water mark of all security labels within the term. Rationale is that a labelled term, which may be disaggregated from the Contract, and must persist the label on the term and on contained elements within other contexts. Requirement - If more than one policy dictates a level of confidentiality of the term, then each applicable policy may be represented by a security label specific to its requirements. Comment - A Security Label is comprised of 1..1 confidentiality code and 0..* other security label codes (aka "privacy tags". A Security Label is metadata assigned (aka "tagged") to Resources and Resource elements, which specify the confidentiality and sensitivity of the Resource or element and their related attributes, the purposes for which tagged items may be collected, access, used or disclosed, any limitation on the type of entities authorized to engage in permitted purposes, and handling instructions that obligate or prohibit certain actions on the tagged items.
Number used to link this term or term element to the applicable Security Label.
Security label privacy tag that species the level of confidentiality protection required for this term and/or term elements.
Security label privacy tag that species the applicable privacy and security policies governing this term and/or term elements.
Security label privacy tag that species the manner in which term and/or term elements are to be protected.
The matter of concern in the context of this agreement provision.
How the party participates in the offer.
The owner of an asset has the residual control rights over the asset: the right to decide all usages of the asset in any way not inconsistent with a prior contract, custom, or law (Hart, 1995, p. 30).
The Contract.topic may be an application for or offer of a policy or service (e.g., uri to a consent directive form or a health insurance policy), which becomes the Contract once accepted by both the grantor and grantee. The Contract Resource may function simply as the computable representation of the executed contract, which may be the attached to the Contract Resource as the “binding” or as the “friendly” electronic form. For example, a Contract Resource may be automatically populated with the values expressed in a related QuestionnaireResponse. However, the Contract Resource may be considered the legally binding contract if it is the only “executed” form of this contract, and includes the signatures as *The Contract Resource may function as the computable representation of an application or offer in a pre-executed Contract if the grantor has not entered any values. In this case, it is populated with values in a “legal” form of the application or offer or by the values in an associated Questionnaire. If the grantor has filled in the legal form or the associated Questionnaire Response, then these values are used to populate a pre-executed Contract Resource. If the Contract.topic is considered an application or offer, then the policy is often required to be attached as the “legal” basis for the application to ensure “informed consent” to the contract, and that any discrepancy between the application and the policy are interpreted against the policy. Implementers should check organizational and jurisdictional policies to determine the relationship among multiple representations of a contract pre- and post-execution.
In the context of a contract, the topic is the matter under consideration in regards to which specific rights, privileges, obligations, restrictions, and prohibitions are binding on any grantor and grantee parties upon the execution of the contract. Given the wide range of contract topics, implementers need to be cognizant of the business use case for which they are designing a FHIR Contract, and narrowly specify the topic being represented with respect to the Contract.type and any specializing Contract.subtype. The same topic, e.g., an asset such as a good or service, such as a real property, medical supply, insurance, information, a procedure or employment, or a manner of conduct, such adherence to a privacy, trust, or security policy, may be the topic of multiple types of contracts. One way to determine the Contract.topic is to answer the question: “What is the object of negotiation?” Answer: The Contract.topic, which may be described with more detail in the [0..*]Contract.valuedItem @ [0..1] Contract.valuedItem.entity[x] Definition: Specific type of Contract Valued Item that may be priced. CodeableConcept|Reference(Any) Contract.topic is “the what” that a grantor is exchanging with a grantee in return for some benefit. Contract.topic is “the what” to which any Contract.action is being applied for any stipulated Contract.action.reason. AContract.topic is “the what” governed by the execution of the contract to which any party’s rights, privileges, obligations, restrictions, and prohibitions apply.
Includes many ActClass, ActCode, RoleClass, RoleCode, EntityClass, EntityCode, ParticipationType codes from HL7 concept domains and code systems. For example, RoleCode: HLD (held entity) Description: Entity that is currently in the possession of a holder (scoper), who holds, or uses it, usually based on some agreement with the owner. MANU (manufactured product) Description: Scoped by the manufacturer. OWN (owned entity) Description: An Entity (player) for which someone (scoper) is granted by law the right to call the material (player) his own. This entitles the scoper to make decisions about the disposition of that material. WRTE (warranted product) Description: A role a product plays when a guarantee is given to the purchaser by the seller (scoping entity) stating that the product is reliable and free from known defects and that the seller will repair or replace defective parts within a given time limit and under certain conditions.
Type of Contract Provision such as specific requirements, purposes for actions, obligations, prohibitions, e.g. life time maximum benefit.
Type of choice made by accepting party with respect to an offer made by an offeror/ grantee.
In some policy or contract contexts, the "offer" is made by an offeror wishing to be the "grantee" of the offer topic by the grantor. From this perspective, the grantor is the "offeree".
The type of decision made by a grantor with respect to an offer made by a grantee.
ActCode: _ActConsentDirective [abstract term] Description: Specifies the type of agreement between one or more grantor and grantee in which rights and obligations related to one or more shared items of interest are allocated. Usage Note: Such agreements may be considered "consent directives" or "contracts" depending on the context, and are considered closely related or synonymous from a legal perspective.
How the decision about a Contract was conveyed.
Response to an offer clause or question text, which enables selection of values to be agreed to, e.g., the period of participation, the date of occupancy of a rental, warrently duration, or whether biospecimen may be used for further research.
Human readable form of this Contract Offer.
The id of the clause or question text of the offer in the referenced questionnaire/response.
.outboundRelationship[typeCode=DEFN].target[classCode=OBS, moodCode=DEFN].id
Security labels that protects the offer.
Target entity type about which the term may be concerned.
May be a subtype or part of an offered asset.
Specifies the applicability of the term to an asset resource instance, and instances it refers to orinstances that refer to it, and/or are owned by the offeree.
The class (type) of information a consent rule covers.
Asset context reference may include the creator, custodian, or owning Person or Organization (e.g., bank, repository), location held, e.g., building, jurisdiction.
Coded representation of the context generally or of the Referenced entity, such as the asset holder type or location.
Description of the quality and completeness of the asset that imay be a factor in its valuation.
Type of Asset availability for use or ownership.
Clause or question text (Prose Object) concerning the asset in a linked form, such as a QuestionnaireResponse used in the formation of the contract.
Id [identifier??] of the clause or question text about the asset in the referenced form or QuestionnaireResponse.
Security labels that protects the asset.
COCT_RM440000UV09 ValuedItem classCode INVE
Specific type of Contract Valued Item that may be priced.
Identifies a Contract Valued Item instance.
Indicates the time during which this Contract ValuedItem information is effective.
COCT_RM440000UV09 ValuedItem effectiveTime
Specifies the units by which the Contract Valued Item is measured or counted, and quantifies the countable or measurable Contract Valued Item instances.
COCT_RM440000UV09 ValuedItem unitQuantity
Contract Valued Item fee, charge, or cost
A Contract Valued Item unit valuation measure.
COCT_RM440000UV09 ValuedItem unitPriceAmt
Contract Valued Item Price Scaling Factor
A real number that represents a multiplier used in determining the overall value of the Contract Valued Item delivered. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
COCT_RM440000UV09 ValuedItem factorNumber
Contract Valued Item Difficulty Scaling Factor
An amount that expresses the weighting (based on difficulty, cost and/or resource intensiveness) associated with the Contract Valued Item delivered. The concept of Points allows for assignment of point values for a Contract Valued Item, such that a monetary amount can be assigned to each point.
COCT_RM440000UV09 ValuedItem pointNumber
Expresses the product of the Contract Valued Item unitQuantity and the unitPriceAmt. For example, the formula: unit Quantity * unit Price (Cost per Point) * factor Number * points = net Amount. Quantity, factor and points are assumed to be 1 if not supplied.
Id of the clause or question text related to the context of this valuedItem in the referenced form or QuestionnaireResponse.
Security Labels that define affected terms
A set of security labels that define which terms are controlled by this condition.
An actor taking a role in an activity for which it can be assigned some degree of responsibility for the activity taking place.
Several agents may be associated (i.e. has some responsibility for an activity) with an activity and vice-versa. For example, in cases of actions initiated by one user for other users, or in events that involve more than one user, hardware device, software, or system process. However, only one user may be the initiator/requestor for the event.
An agent can be a person, an organization, software, device, or other entities that may be ascribed responsibility.
If true this element negates the specified action. For Example, instead of a dictate to perform an action, it is a dictate not to perform the action.
Activity or service obligation to be done or not done, performed or not performed, effectuated or not by this Contract term.
The entity the action is performed or not performed on or for.
Role type of agent assigned roles in this Contract.
Detailed codes for the contract actor role.
RoleClass, RoleCode, ParticipationType, ParticipationFunction codes
Reason or purpose for the action stipulated by this Contract Provision.
Detailed codes for the contract action reason.
Examples from ActReason Concept Domains: ActCoverageReason Description:Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties. ActInformationPrivacyReason Description: The rationale or purpose for an act relating to the management of personal information, such as disclosing personal tax information for the purpose of complying with a court order. ClinicalResearchObservationReason Definition: Specifies the reason that a test was performed or observation collected in a clinical research study. SafetyInvestigationReportReasonType Description: Possible reasons generating a report providing information developed during the investigation of an adverse event or a product problem. ControlActReason Description: Indicates the motivation, cause or rationale of an Act which results in a trigger event. NonPerformanceReasonCode Description: The reason the action was not performed, e.g. why the medication was not taken. If an action was not performed, it is often clinically important to know why the action was not taken. RefusalReasonCode Description: Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action. Examples from HL7 ActReason Code System: QUALIMP (quality improvement) Description:Operational activities conducted for the purposes of improving the quality of an activity, product, or service. _PatientProfileQueryReasonCode Description: A collection of concepts identifying why the patient's profile is being queried. _ActInformationManagementReason Description:The rationale or purpose for an act relating to information management, such as archiving information for the purpose of complying with an enterprise data retention policy. _ActInvalidReason (ActInvalidReason) Description: Types of reasons why a substance is invalid for use. _NonPerformanceReasonCode Description: The reason the action wasn't performed, e.g. why the medication was not taken. If an action wasn"t performed, it is often clinically important to know why the action wasn"t taken.
Id [identifier??] of the clause or question text related to this action in the referenced form or QuestionnaireResponse.
Encounter or Episode with primary association to specified term activity.
Id [identifier??] of the clause or question text related to the requester of this action in the referenced form or QuestionnaireResponse.
Who or what initiated the action and has responsibility for its activation.
The type of individual that is desired or required to perform or not perform the action.
The type of role or competency of an individual desired or required to perform or not perform the action.
Codes for the role of the action performer.
Actor that wil execute (or not) the action
Indicates who or what is being asked to perform (or not perform) the ction.
Id [identifier??] of the clause or question text related to the reason type or reference of this action in the referenced form or QuestionnaireResponse.
Rationale for the action to be performed or not performed. Describes why the action is permitted or prohibited.
Indicates another resource whose existence justifies permitting or not permitting this action.
Describes why the action is to be performed or not performed in textual form.
Comments made about the term action made by the requester, performer, subject or other participants.
Security labels that protects the action.
Information that may be needed by/relevant to the performer in their execution of this term action.
Links to Provenance records for past versions of this Contract definition, derivative, or instance, which identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the Contract. The Provence.entity indicates the target that was changed in the update. http://build.fhir.org/provenance-definitions.html#Provenance.entity.
Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature
FHIR includes a preferred coding for contract signatory roles, which map well to the eLTSS signatories. The primary one for the patient/beneficiary is "PAT" (patient), although implementers may use others as well. However, implementers must realize that type may be used to differentiate between the patient, service provider, planner, etc. so there need to be distinct role types utilized.
The Contract.signer applies a signature to the Contract.binding referenced resource, which is the documentation that is the legal "source of truth". The Contract.signer may delegate, such as a legally recognized personal representative, or have a delegate assigned e.g., by a court of law, to actually sign the Contract, such as a trustee in the case of incompetence.
Role of this Contract signer, e.g. notary, grantee.
Would probably use "CONSENTER" which represents "consent signature" in this use case.
RoleClass, RoleCode, ParticipationType, ParticipationFunction class codes.
Person, Guardian / Legal Representative, Support Planner, or Service Provider Printed Name
Legally binding Contract DSIG signature contents encoded in Base64.
Participation.signatureCode :: CD (0..1) Definition: Whether the participant has attested participation through a signature, or whether such a signature is needed. Examples: A surgical Procedure act object (representing a procedure report) requires a signature of the performing and responsible surgeon, and possibly other participants; The participant intends to provide a signature. Participation.signatureText :: ED (0..1) Definition: A textual or multimedia depiction of the signature by which the participant endorses and accepts responsibility for his or her participation in the Act as specified in the Participation.typeCode. UsageNotes: The signature can be represented either inline or by reference according to the ED data type. Typical cases are 1) Paper-based signatures: the ED data type may refer to a document or other resource that can be retrieved through an electronic interface to a hardcopy archive. 2) Electronic signature: this attribute can represent virtually any electronic signature scheme. 3) Digital signature: this attribute can represent digital signatures by reference to a signature data block that is constructed in accordance to a digital signature standard, such as XML-DSIG, PKCS#7, PGP, etc. Examples: 1) An "author" participant assumes accountability for the truth of the Act statement to the best of his knowledge. 2) An information recipient only attests to the fact that he or she has received the information.
Extensions are always sliced by (at least) url
Indication of the reason the entity signed the object(s)
An indication of the reason that the entity signed this document. This may be explicitly included as part of the signature information and can be used when determining accountability for various actions concerning the document.
Would probably use "1.2.840.10065.1.12.1.7" which represents "consent signature" in this use case.
An indication of the reason that an entity signed the object.
Person, Guardian / Legal Representative, Support Planner, or Service Provider Signature Date
This should agree with the information in the signature.
Person, Guardian/Legal Representative, Support Planner, or Service Provider Printed Name
A reference to an application-usable description of the identity that is represented by the signature.
The party that can't sign. For example a child.
used when the signature is on behalf of a non-signer.
The technical format of the signed resources
A mime type that indicates the technical format of the target resources signed by the signature.
"xml", "json" and "ttl" are allowed, which describe the simple encodings described in the specification (and imply appropriate bundle support). Otherwise, mime types are legal here.
The mime type of an attachment. Any valid mime type is allowed.
A mime type that indicates the technical format of the signature. Important mime types are application/signature+xml for X ML DigSig, application/jose for JWS, and image/* for a graphical image of a signature, etc.
The actual signature content (XML DigSig. JWS, picture, etc.)
The base64 encoding of the Signature content. When signature is not recorded electronically this element would be empty.
Where the signature type is an XML DigSig, the signed content is a FHIR Resource(s), the signature is of the XML form of the Resource(s) using XML-Signature (XMLDIG) "Detached Signature" form.
The "patient friendly language" versionof the Contract in whole or in parts. "Patient friendly language" means the representation of the Contract and Contract Provisions in a manner that is readily accessible and understandable by a layperson in accordance with best practices for communication styles that ensure that those agreeing to or signing the Contract understand the roles, actions, obligations, responsibilities, and implication of the agreement.
Easily comprehended representation of this Contract
Human readable rendering of this Contract in a format and representation intended to enhance comprehension and ensure understandability.
Act.text Definition: A renderable textual or multimedia description (or reference to a description) of the complete information which would reasonably be expected to be displayed to a human reader conveyed by the Act.
List of Legal expressions or representations of this Contract.
Contract legal text in human renderable form.
Example: Act.text of an Act coded as with ActPrivacyLaw, ActPolicy code
List of Computable Policy Rule Language Representation(s) of this Contract.
Computable Contract conveyed using a policy rule language (e.g. XACML, DKAL, SecPal).
Computable Policy Consent [Observation: templateId 2.16.840.1.113883.3.445.16] This template is used to represent an alternative representation of the Privacy Consent Directive (e.g.,ODRL, XrML, XACML) as a computer-readable set of rules. An implementation may use any appropriate representations of the privacy consent in addition to the "ConsentDirectiveStructuredDefinition" which uses the Clinical Template structure to express the elements of a consent directive in an interoperable way. 1. SHALL contain exactly one [1..1] templateId ( CONF-CD-16 ) such that it a. SHALL contain exactly one [1..1] @root="2.16.840.1.113883.3.445.16" 2. SHALL contain exactly one [1..1] @moodCode="DEF" (CodeSystem: 2.16.840.1.113883.5.1001 HL7ActMood) (CONF:14912) 3. SHALL contain exactly one [1..1] code (CONF:9139)/@code="57016-8" Privacy Policy Acknowledgement Document (CodeSystem: 2.16.840.1.113883.6.1 LOINC) (CONF:9138) It specifies the LOINC code corresponding to "Privacy Policy Acknowledgement Document", it is fixed at this value. 4. SHOULD contain zero or more [0..*] value with @xsi:type="ANY" (CONF:9140) The value contains the computable representation of the policy. This may be a standard-based access control or attribute control based policy (See "References"). Computable Policy Consent example <entryRelationship typeCode="COMP"> <templateId root="2.16.840.1.113883.3.445.16" /> <observationMedia classCode="OBS" moodCode="EVN"> <value mediaType="text/xml" representation="TXT"> ... </value> </observationMedia> </entryRelationship>
Legally binding Contract: This is the signed and legally recognized representation of the Contract, which is considered the "source of truth" and which would be the basis for legal action related to enforcement of this Contract.
DocumentCompletion code system AU (authenticated) Description: A completion status in which a document has been signed manually or electronically by one or more individuals who attest to its accuracy. No explicit determination is made that the assigned individual has performed the authentication. While the standard allows multiple instances of authentication, it would be typical to have a single instance of authentication, usually by the assigned individual.