Union of http://hl7.org/fhir/CodeSystem/obligation and http://hl7.org/fhir/CodeSystem/obligation

This is the CodeSystem that contains all the codes in Obligation Codes (http://hl7.org/fhir/CodeSystem/obligation) and Obligation Codes (http://hl7.org/fhir/CodeSystem/obligation). E.g. what you have to deal with if you get resources containing codes in either of them

CodeSystem

Generated Narrative: CodeSystem 3099ac23-0942-4450-b678-d1831a38da6f-62

Properties

This code system defines the following properties for its concepts

NameCodeURITypeDescription
qualifyqualifybooleanCodes with this property true must have 'shall', 'should', or 'may' prepended in the grammar
combinationcombinationcodeOne of the codes that makes up a composite codes
qualifyqualifybooleanCodes with this property true must have 'shall', 'should', or 'may' prepended in the grammar
combinationcombinationcodeOne of the codes that makes up a composite codes
Not Selectablenot-selectablehttp://hl7.org/fhir/concept-properties#notSelectablebooleanCodes with this property set are not intended to appear in instances. They are for grouping/subsetting purposes only.
Parentparenthttp://hl7.org/fhir/concept-properties#parentcode
qualifierqualifierhttp://hl7.org/fhir/CodeSystem/obligation#qualifiercodeIndicates the level of adherence expected to the obligation concept
converseconversehttp://hl7.org/fhir/CodeSystem/obligation#conversecodeIndicates another obligation code with an opposite meaning to this one. A single obligation cannot list two converse codes and an application cannot satisfy both a code and its coverse (though if the obligation strength for both is SHOULD or MAY, an application could conform with both obligations by adhering to one and not the other).
security-dependentsecurity-dependenthttp://hl7.org/fhir/CodeSystem/obligation#security-dependentbooleanObligation codes with this property set to true may be overridden by policies and regulations related to privacy and security, including patient consent. Testing of such obligations will need to take such considerations into account.

Concepts

This code system http://hl7.org/fhir/comparison/CodeSystem/3099ac23-0942-4450-b678-d1831a38da6f-62 defines codes in an undefined hierarchy, but no codes are represented here

LvlCodeDisplayDefinitioncombinationcombinationNot SelectableParent
1ModifierCodes ModifierCodes

SHALL/SHOULD/MAY that can be prepended to codes that have the qualify property = true

2  SHALL SHALL

The functional requirement is mandatory. Applications that do not implement this functional behavior are considered non-conformant

2  SHOULD SHOULD

The functional requirement is a recommendation

2  MAY MAY

The functional requirement is presented as an option for applications to consider. Note that this is usually used to indicate a choice is still valid for an application to make

1ResourceProducerObligations ResourceProducerObligations

Resource producers are applications that assembles resources in the first place. Resource producers may be a server, client, sender, receiver or some middleware device, and they may store the resource, or merely hand it on.

2  can-send Conformant Applications SHALL/SHOULD/MAY be able to correctly populate this element

Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value

3    will-send Conformant Applications SHALL/SHOULD/MAY be capable of sending this element and, if the element has a value and is allowed to be shared, include it when sending the resource

Notes: This implementation obligation means that whenever the producer knows the correct value for an element, it populates it, subject to security, consent and privacy considerations

2  use-reason Conformant Applications SHALL/SHOULD/MAY provide an element with a DataAbsentReason or a NullFlavor (or equivalent) if a value is not known and the element is mandatory

Notes: When no value for an element is known, the producer populates the element with a DataAbsentReason or a NullFlavor (or equivalent). If no particular reason is known or reportable, the DataAbsentReason 'unknown' is used. Which particular extension can be used, see below

2  in-narrative Conformant Applications SHALL/SHOULD/MAY ensure that this data element is represented in any human readable representation in a resource

Notes: When no value for an element is known, the producer populates the element with a DataAbsentReason or a NullFlavor (or equivalent). If no particular reason is known or reportable, the DataAbsentReason 'unknown' is used. Which particular extension can be used, see below

2  in-ui Conformant Applications SHALL/SHOULD/MAY ensure that users can enter a value for this element during data input

Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application

2  in-store Conformant Applications SHALL/SHOULD/MAY ensure that the value for this element is stored in a persistent data store

Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understand that the same value will be available in later exchanges

2  must-explain Documentation applicable to Conformant Applications SHALL/SHOULD/MAY explain how this element is handled

Notes: this is really a rule about specifications, implying that another specification (which might be application documentation) either makes this element will-send, or explains how the use cases that involve this element do not arise, or how they are handled. An example: IPA marks Patient.active must-handle and must-explain. Client applications must process Patient.active correctly if they see it, but many (though not all) specifications and/or applications ensure that Patient.active will never be false, and so it will never be populated e.g. MedMij in Netherlands prohibits use of Patient.active, and explains that it is never false.

2  can-send Conformant Applications SHALL/SHOULD/MAY be able to correctly populate this element

Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value

3    will-send Conformant Applications SHALL/SHOULD/MAY be capable of sending this element and, if the element has a value and is allowed to be shared, include it when sending the resource

Notes: This implementation obligation means that whenever the producer knows the correct value for an element, it populates it, subject to security, consent and privacy considerations

2  use-reason Conformant Applications SHALL/SHOULD/MAY provide an element with a DataAbsentReason or a NullFlavor (or equivalent) if a value is not known and the element is mandatory

Notes: When no value for an element is known, the producer populates the element with a DataAbsentReason or a NullFlavor (or equivalent). If no particular reason is known or reportable, the DataAbsentReason 'unknown' is used. Which particular extension can be used, see below

2  in-narrative Conformant Applications SHALL/SHOULD/MAY ensure that this data element is represented in any human readable representation in a resource

Notes: When no value for an element is known, the producer populates the element with a DataAbsentReason or a NullFlavor (or equivalent). If no particular reason is known or reportable, the DataAbsentReason 'unknown' is used. Which particular extension can be used, see below

2  in-ui Conformant Applications SHALL/SHOULD/MAY ensure that users can enter a value for this element during data input

Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application

2  in-store Conformant Applications SHALL/SHOULD/MAY ensure that the value for this element is stored in a persistent data store

Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understand that the same value will be available in later exchanges

2  must-explain Documentation applicable to Conformant Applications SHALL/SHOULD/MAY explain how this element is handled

Notes: this is really a rule about specifications, implying that another specification (which might be application documentation) either makes this element will-send, or explains how the use cases that involve this element do not arise, or how they are handled. An example: IPA marks Patient.active must-handle and must-explain. Client applications must process Patient.active correctly if they see it, but many (though not all) specifications and/or applications ensure that Patient.active will never be false, and so it will never be populated e.g. MedMij in Netherlands prohibits use of Patient.active, and explains that it is never false.

1ExchangerObligations ExchangerObligations

Exchangers do not produce or consume resources; they only pass the resource on. They may store the resource in a persistent store between reception and subsequent transfer. The generic FHIR servers are exchangers, as are most middleware systems.

2  unaltered Conformant Applications SHALL/SHOULD/MAY ensure that this element does not change between receiving and transfer

Notes: This does not mean that the element value cannot change, only that changing the element value for an element marked with this obligation moves an application from being an exchanger to a Consumer and a Producer, and those obligations apply

2  may-alter Conformant Applications MAY choose not to alter this element value

Notes: this is the converse of preserve, and is really a null-statement - it's the default rule for an application. It's defined here to allow a specification to be explicit that it isn't conveying obligations for resource producers

1ResourceConsumerObligations ResourceConsumerObligations

Resource Consumers are applications that consume resources and do something with them, either displaying them to humans, transferring them to some other format for further re-use, or using them to drive some kind of application logic process AKA decision support. Resource Consumers often store resources, but do not need to, and whether resources are stored or not between receiving them and using them doesn't make any difference to the obligations

2  no-error Conformant Applications SHALL/SHOULD/MAY accept resources containing any valid value for the element without error

Notes: Applications are still able to inform the user that a value cannot be processed correctly, but applications aren't able to reject the information out of hand or ignore the element value in order to process the resource correctly (which would be allowed for elements that do not have this obligation). This obligation also applies to elements that only contain a DataAbsentReason or a NullFlavor (or equivalent), should either of these be allowed on the consumer obligations

2  handle Conformant Applications SHALL/SHOULD/MAY handle the meaning of this element correctly

Notes: this rule is vague in that doesn't specify any particular handling of the element. But it's important because an application that ignores this element is non-conformant. A good example would be a status code of 'entered-in-error' - how exactly a Resource Consumer handles this depends on the use case etc, but the application can never simply ignore such a status code. Note that whether the resource or information from it is stored for later use is irrelevant - when the resource or information in it is processed, the consequences of the element are considered. That may mean not retaining the information for later use, or informing the user, etc. Typically, this obligation marks that there are known patient safety issues that can arise if the element is ignored. Implementers should pay particular attention to the possible range of values for the element from a safety perspective.

3    display Conformant Applications SHALL/SHOULD/MAY display the value of this element when presenting the data from the resource to a human user

Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource

3    share Conformant Applications SHALL/SHOULD/MAY retain the value of this element when the information from the resource is shared with other applications

Notes: this rule applies whether the information is being shared in the form of a FHIR resource, or in some other format. The rule applies whether or not the resource is stored prior to sharing.

3    process Conformant Applications SHALL/SHOULD/MAY consider the value of this element when processing the resource as specified by the IG

Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG DataAbsentReason or NullFlavor or equivalent when handling the resource or the information in it as specified by the other obligations.

3    store Conformant Applications SHALL/SHOULD/MAY store the value of this element in a persistent data store

Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understand that the same value will be available in later exchanges

3    print Conformant Applications SHALL/SHOULD/MAY print the value of this element somewhere

Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow

3    ignore Conformant Applications SHALL/SHOULD/MAY ignore the value of this element somewhere

Notes: This is different to can-ignore, which indicates that the application may ignore it. This is an expectation that it will be ignored

3    preserve Conformant Applications SHALL/SHOULD/MAY keep the value of this element exactly

Notes: this is an expectation that future references to the value, whether produced or consumed, will be to the exact same data. Alternative or truncated data is not allowed

3    modify Conformant Applications SHALL/SHOULD/MAY keep the value of this element exactly

Notes: this is an expectation that future references to the value, whether produced or consumed, will be to the exact same data. Alternative or truncated data is not allowed

2  no-error Conformant Applications SHALL/SHOULD/MAY accept resources containing any valid value for the element without error

Notes: Applications are still able to inform the user that a value cannot be processed correctly, but applications aren't able to reject the information out of hand or ignore the element value in order to process the resource correctly (which would be allowed for elements that do not have this obligation). This obligation also applies to elements that only contain a DataAbsentReason or a NullFlavor (or equivalent), should either of these be allowed on the consumer obligations

2  handle Conformant Applications SHALL/SHOULD/MAY handle the meaning of this element correctly

Notes: this rule is vague in that doesn't specify any particular handling of the element. But it's important because an application that ignores this element is non-conformant. A good example would be a status code of 'entered-in-error' - how exactly a Resource Consumer handles this depends on the use case etc, but the application can never simply ignore such a status code. Note that whether the resource or information from it is stored for later use is irrelevant - when the resource or information in it is processed, the consequences of the element are considered. That may mean not retaining the information for later use, or informing the user, etc. Typically, this obligation marks that there are known patient safety issues that can arise if the element is ignored. Implementers should pay particular attention to the possible range of values for the element from a safety perspective.

3    display Conformant Applications SHALL/SHOULD/MAY display the value of this element when presenting the data from the resource to a human user

Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource

3    share Conformant Applications SHALL/SHOULD/MAY retain the value of this element when the information from the resource is shared with other applications

Notes: this rule applies whether the information is being shared in the form of a FHIR resource, or in some other format. The rule applies whether or not the resource is stored prior to sharing.

3    process Conformant Applications SHALL/SHOULD/MAY consider the value of this element when processing the resource as specified by the IG

Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG DataAbsentReason or NullFlavor or equivalent when handling the resource or the information in it as specified by the other obligations.

3    store Conformant Applications SHALL/SHOULD/MAY store the value of this element in a persistent data store

Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understand that the same value will be available in later exchanges

3    print Conformant Applications SHALL/SHOULD/MAY print the value of this element somewhere

Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow

3    ignore Conformant Applications SHALL/SHOULD/MAY ignore the value of this element somewhere

Notes: This is different to can-ignore, which indicates that the application may ignore it. This is an expectation that it will be ignored

3    preserve Conformant Applications SHALL/SHOULD/MAY keep the value of this element exactly

Notes: this is an expectation that future references to the value, whether produced or consumed, will be to the exact same data. Alternative or truncated data is not allowed

3    modify Conformant Applications SHALL/SHOULD/MAY keep the value of this element exactly

Notes: this is an expectation that future references to the value, whether produced or consumed, will be to the exact same data. Alternative or truncated data is not allowed

1AggregateConcepts AggregateConcepts

Predefined common combinations

2  can-populate A Conformant Application MAY choose to populate this element or not

Notes: this is the converse of will-send, and is really a null-statement - it's the default rule for an application. It's defined here to allow a specification to be explicit that it isn't conveying obligations for resource producers

MAY:will-sendMAY:will-send
2  can-ignore A Conformant Application MAY ignore this element

Notes: this is the converse of must-handle, and is really a null-statement - it's the default rue for an application. It's defined here to allow a specification to be explicit that it isn't converying obligations for resource consumers

2  v2-re V2 RE

RE as defined in chapter 2 of the v2 specification

2  ihe-r2 IHE R2

R2 as defined in IHE Appendix Z

2  std Standard Obligations

The standard recommended set of obligations for IGs to use unless they know they want something different. Note that the standard codes don't include use-dar, use-dar-nf, use-dar-if-allowed / use-reason - that gets put on specific elements that justify this handling

1SHALL SHALL

The functional requirement is mandatory. Applications that do not implement this functional behavior are considered non-conformant.

true
1SHOULD SHOULD

The functional requirement is a recommendation. Applications are strongly encouraged to implement this functional behavior, but are still conformant if they do not.

true
1MAY MAY

The functional requirement is an option worthy of consideration but there is no expectation or recommendation associated with its use. NOTE: Elements not flagged with any obligation are intrinsically still 'MAY' (unless constraints dictate otherwise), but have not specifically been called out by the author as worthy of consideration.

true
1ResourceExchangerObligations ResourceExchangerObligations

Exchangers do not produce or consume resources; they only pass the resource on. They may store the resource in a persistent store between reception and subsequent transfer. The generic FHIR servers are exchangers, as are most middleware systems. Note that Exchanger obligations may also be taken on by Producers or Consumers if they act as intermediaries between other systems or between systems and users.

true
1able-to-populate be able to populate

Conformant applications producing resources SHALL/SHOULD/MAY be able to correctly populate this element. Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value. (i.e. not a data-absent-reason or equivalent.) This obligation does not impose expectations on the circumstances in which the element will be sent, only that it can be in at least some situations.

trueResourceProducerObligations
1populate-if-known populate if known

Conformant applications producing resources SHALL/SHOULD correctly populate this element if they know a value for the element, but it is acceptable if the system is unable to ever know a value for the element. Notes: This obligation does not impose a requirement to be able to know a value, unlike populate and able-to-populate which do. 'Knowing' an element means that a value for the element is available in memory, persistent store, or is otherwise available within the system claiming conformance.

trueResourceProducerObligations
1populate populate

Conformant applications producing resources SHALL/SHOULD include this element if a value is known and allowed to be shared. Notes: This implementation obligation means that whenever the producer knows the correct value for an element, it populates it. This is NOT the same as cardinality, as a 'populate' element can be omitted if no data exists or the data that exists is prohibited from being shared.

truepopulate-if-known, able-to-populate
1in-narrative include in narrative

Conformant applications SHALL/SHOULD/MAY ensure that this data element is represented in any human readable representation of a resource. Notes: When no value for an element is known, the producer populates the narrative with the content of any nested ElementDefinition.valueAlternatives extensions such as DataAbsentReason. If no particular reason is known or reportable, the element can simply be indicated as 'unknown' in the narrative.

trueResourceProducerObligations
1exclude-narrative exclude from narrative

Conformant applications SHALL/SHOULD ensure that this data element is NOT represented in any human readable representation of a resource. Notes: This may be useful for profiles related to de-identified records

trueResourceProducerObligations
1user-input allow user input

Conformant applications SHALL/SHOULD/MAY ensure that users can enter a value for this element during data input/capture. Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application.

trueResourceProducerObligations
1explain populate or document irrelevance

Documentation applicable to Conformant applications SHALL/SHOULD explain how this element is handled. Notes: this is really a rule about specifications, implying that another specification (which might be application documentation) either makes this element populate, or explains how the use cases that involve this element do not arise, or how they are handled. An example: IPA marks Patient.active must-handle and must-explain. Client applications must process Patient.active correctly if they see it, but many (though not all) specifications and/or applications ensure that Patient.active will never be false, and so it will never be populated e.g. MedMij in Netherlands prohibits use of Patient.active, and explains that it is never false.

trueResourceProducerObligations
1persist persist

Conformant applications SHALL/SHOULD/MAY ensure that the value for this element is stored in a persistent data store. Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understood that the same value will be available in later exchanges

trueResourceConsumerObligations, ResourceProducerObligations
1no-alter not alter

Conformant applications SHALL/SHOULD ensure that this element does not change between receiving and transfer. Notes: This does not mean that the element value cannot change, only that changing the element value for an element marked with this obligation moves an application from being an exchanger to a Consumer and a Producer, and those obligations apply

trueResourceExchangerObligations
1no-error not error if present

Conformant applications SHALL/SHOULD accept resources containing any valid value for the element without error. Notes: Applications are still able to inform the user that a value cannot be processed correctly and may ignore the data, but applications aren't able to reject an instance merely because the element is present (which would be allowed for elements that do not have this obligation). A system MAY raise an error if the value provided is not valid or violates specific business rules. This obligation also applies to elements that only contain an extension in place of a value where (or equivalent), should either of these be allowed on the consumer obligations

trueResourceConsumerObligations
1reject-invalid reject invalid

Conformant applications SHALL/SHOULD check that values for this element meet all data constraints asserted within the profile declaring this obligation. If validity issues are found, the system SHALL/SHOULD not accept the instance. Notes: This applies to validating the element with the obligation, but not resources referenced by it.

trueResourceConsumerObligations
1accept-invalid accept invalid

Conformant applications SHALL/SHOULD accept data that does not meet all data constraints asserted within the profile declaring this obligation. This applies to non-valid constraints, not to non-valid syntax or failure to meet base resource validity expectations. Typically used when a system needs to be able to handle data that does not adhere to desired expectations (legacy data, test data, data undergoing authorship that is not yet complete, etc.)

trueResourceConsumerObligations
1handle correctly handle

Conformant applications SHALL/SHOULD handle the meaning of this element correctly. Notes: this rule is vague in that doesn't specify any particular handling of the element. But it's important because an application that ignores this element is non-conformant. A good example would be a status code of 'entered-in-error' - how exactly a Resource Consumer handles this depends on the use case etc., but the application can never simply ignore such a status code. Note that whether the resource or information from it is stored for later use is irrelevant - when the resource or information in it is processed, the consequences of the element are considered. That may mean not retaining the information for later use, or informing the user, etc. Typically, this obligation marks that there are known patient safety issues that can arise if the element is ignored. Implementers should pay particular attention to the possible range of values for the element from a safety perspective.

trueResourceConsumerObligations
1display display

Conformant applications SHALL/SHOULD/MAY display the value of this element when presenting the data from the resource to a human user. Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource

truehandle
1process process

Conformant applications SHALL/SHOULD/MAY consider the value of this element when processing the resource as specified by the IG. Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG of any ElementDefinition.valueAlternatives extensions as well as the value (or other extensions explicitly declared beneath the element in the profile containing the obligation. Examples might include consideration in decision support, consideration in claims evaluation, etc.

truehandle
1print print

Conformant applications SHALL/SHOULD/MAY print the value of this element somewhere. Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow

truehandle
1ignore ignore

Conformant applications SHALL/SHOULD/MAY not make any use of the value of this element if received.

trueResourceConsumerObligations
1SHALL:able-to-populate SHALL be able to populate

Conformant applications producing resources SHALL be able to correctly populate this element. Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value. (i.e. not a data-absent-reason or equivalent.) This obligation does not impose expectations on the circumstances in which the element will be sent, only that it can be in at least some situations.

able-to-populate
1SHOULD:able-to-populate SHOULD be able to populate

Conformant applications producing resources SHOULD be able to correctly populate this element. Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value. (i.e. not a data-absent-reason or equivalent.) This obligation does not impose expectations on the circumstances in which the element will be sent, only that it shold be in at least some situations.

able-to-populate
1MAY:able-to-populate MAY be able to populate

Conformant applications producing resources MAY be able to correctly populate this element. Notes: Typically, this means that an application needs to demonstrate during some conformance testing process that there are some conditions under which it populates the element with a correct value. (i.e. not a data-absent-reason or equivalent.) This obligation does not impose expectations on the circumstances in which the element will be sent, only that it may be in at least some situations. This is a null statement and is the default behavior for originating systems if other obligations are not specified.

able-to-populate
1SHALL:populate-if-known SHALL populate if known

Conformant applications producing resources SHALL correctly populate this element if they know a value for the element, but it is acceptable if the system is unable to ever know a value for the element. Notes: This obligation does not impose a requirement to be able to know a value, unlike populate and able-to-populate which do. 'Knowing' an element means that a value for the element is available in memory, persistent store, or is otherwise available within the system claiming conformance.

populate-if-known
1SHOULD:populate-if-known SHOULD populate if known

Conformant applications producing resources SHOULD correctly populate this element if they know a value for the element, but it is acceptable if the system is unable to ever know a value for the element. Notes: This obligation does not impose a requirement to be able to know a value, unlike populate and able-to-populate which do. 'Knowing' an element means that a value for the element is available in memory, persistent store, or is otherwise available within the system claiming conformance.

populate-if-known
1SHALL:populate SHALL populate

Conformant applications producing resources SHALL include this element if a value is known and allowed to be shared. Notes: This implementation obligation means that whenever the producer knows the correct value for an element, it populates it. This is NOT the same as cardinality, as a 'populate' element can be omitted if no data exists or the data that exists is prohibited from being shared.

SHALL:able-to-populate, populate
1SHOULD:populate SHOULD populate

Conformant applications producing resources SHOULD include this element if a value is known and allowed to be shared. Notes: This implementation obligation means that whenever the producer knows the correct value for an element, it should populate it. This is NOT the same as cardinality, as a 'populate' element can be omitted if no data exists or the data that exists is prohibited from being shared.

SHOULD:able-to-populate, populate
1SHALL:in-narrative SHALL include in narrative

Conformant applications SHALL ensure that this data element is represented in any human readable representation of a resource. Notes: When no value for an element is known, the producer populates the narrative with the content of any nested ElementDefinition.valueAlternatives extensions such as DataAbsentReason. If no particular reason is known or reportable, the element can simply be indicated as 'unknown' in the narrative.

in-narrative
1SHOULD:in-narrative SHOULD include in narrative

Conformant applications SHOULD ensure that this data element is represented in any human readable representation of a resource. Notes: When no value for an element is known, the producer populates the narrative with the content of any nested ElementDefinition.valueAlternatives extensions such as DataAbsentReason. If no particular reason is known or reportable, the element can simply be indicated as 'unknown' in the narrative.

in-narrative
1MAY:in-narrative MAY include in narrative

Conformant applications MAY ensure that this data element is represented in any human readable representation of a resource. Notes: When no value for an element is known, the producer populates the narrative with the content of any nested ElementDefinition.valueAlternatives extensions such as DataAbsentReason. If no particular reason is known or reportable, the element can simply be indicated as 'unknown' in the narrative.

in-narrative
1SHALL:exclude-narrative SHALL exclude from narrative

Conformant applications SHALL ensure that this data element is NOT represented in any human readable representation of a resource. Notes: This may be useful for profiles related to de-identified records

exclude-narrative
1SHOULD:exclude-narrative SHOULD exclude from narrative

Conformant applications SHOULD ensure that this data element is NOT represented in any human readable representation of a resource. Notes: This may be useful for profiles related to de-identified records

exclude-narrative
1SHALL:user-input SHALL allow user input

Conformant applications SHALL ensure that users can enter a value for this element during data input/capture. Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application.

user-input
1SHOULD:user-input SHOULD allow user input

Conformant applications SHOULD ensure that users can enter a value for this element during data input/capture. Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application.

user-input
1MAY:user-input MAY allow user input

Conformant applications MAY ensure that users can enter a value for this element during data input/capture. Notes: Exactly what form the input takes is not specified, but the expectation is that this is a value that comes from the user, and not implied internally by the application.

user-input
1SHALL:explain SHALL populate or document irrelevance

Documentation applicable to Conformant applications SHALL explain how this element is handled. Notes: this is really a rule about specifications, implying that another specification (which might be application documentation) either makes this element populate, or explains how the use cases that involve this element do not arise, or how they are handled. An example: IPA marks Patient.active must-handle and must-explain. Client applications must process Patient.active correctly if they see it, but many (though not all) specifications and/or applications ensure that Patient.active will never be false, and so it will never be populated e.g. MedMij in Netherlands prohibits use of Patient.active, and explains that it is never false.

explain
1SHOULD:explain SHOULD populate or document irrelevance

Documentation applicable to Conformant applications SHOULD explain how this element is handled. Notes: this is really a rule about specifications, implying that another specification (which might be application documentation) either makes this element populate, or explains how the use cases that involve this element do not arise, or how they are handled. An example: IPA marks Patient.active must-handle and must-explain. Client applications must process Patient.active correctly if they see it, but many (though not all) specifications and/or applications ensure that Patient.active will never be false, and so it will never be populated e.g. MedMij in Netherlands prohibits use of Patient.active, and explains that it is never false.

explain
1SHALL:persist SHALL persist

Conformant applications SHALL ensure that the value for this element is stored in a persistent data store. Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understood that the same value will be available in later exchanges

persist
1SHOULD:persist SHOULD persist

Conformant applications SHOULD ensure that the value for this element is stored in a persistent data store. Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understood that the same value will be available in later exchanges

persist
1MAY:persist MAY persist

Conformant applications MAY ensure that the value for this element is stored in a persistent data store. Notes: Exactly what the data store is not specified, nor how long it is stored for, but it is understood that the same value will be available in later exchanges

persist
1SHALL:no-alter SHALL not alter

Conformant applications SHALL ensure that this element does not change between receiving and transfer. Notes: This does not mean that the element value cannot change, only that changing the element value for an element marked with this obligation moves an application from being an exchanger to a Consumer and a Producer, and those obligations apply

no-alter
1SHOULD:no-alter SHOULD not alter

Conformant applications SHOULD ensure that this element does not change between receiving and transfer. Notes: This does not mean that the element value cannot change, only that changing the element value for an element marked with this obligation moves an application from being an exchanger to a Consumer and a Producer, and those obligations apply

no-alter
1MAY:alter MAY alter

Conformant applications MAY choose to alter this element value. Notes: this is really a null-statement - it's the default rule for an application. It's defined here to allow a specification to be explicit that it isn't conveying obligations for resource producers

ResourceExchangerObligations
1SHALL:no-error SHALL not error if present

Conformant applications SHALL accept resources containing any valid value for the element without error. Notes: Applications are still able to inform the user that a value cannot be processed correctly and may ignore the data, but applications aren't able to reject an instance merely because the element is present (which would be allowed for elements that do not have this obligation). A system MAY raise an error if the value provided is not valid or violates specific business rules. This obligation also applies to elements that only contain an extension in place of a value where (or equivalent), should either of these be allowed on the consumer obligations

no-error
1SHOULD:no-error SHOULD not error if present

Conformant applications SHOULD accept resources containing any valid value for the element without error. Notes: Applications are still able to inform the user that a value cannot be processed correctly and may ignore the data, but applications aren't able to reject an instance merely because the element is present (which would be allowed for elements that do not have this obligation). A system MAY raise an error if the value provided is not valid or violates specific business rules. This obligation also applies to elements that only contain an extension in place of a value where (or equivalent), should either of these be allowed on the consumer obligations

no-error
1SHALL:reject-invalid SHALL reject invalid

Conformant applications SHALL check that values for this element meet all data constraints asserted within the profile declaring this obligation. If validity issues are found, the system SHALL not accept the instance. Notes: This applies to validating the element with the obligation, but not resources referenced by it.

reject-invalid
1SHOULD:reject-invalid SHOULD reject invalid

Conformant applications SHOULD check that values for this element meet all data constraints asserted within the profile declaring this obligation. If validity issues are found, the system SHOULD not accept the instance. Notes: This applies to validating the element with the obligation, but not resources referenced by it.

reject-invalid
1SHALL:accept-invalid SHALL accept invalid

Conformant applications SHALL accept data that does not meet all data constraints asserted within the profile declaring this obligation. This applies to non-valid constraints, not to non-valid syntax or failure to meet base resource validity expectations. Typically used when a system needs to be able to handle data that does not adhere to desired expectations (legacy data, test data, data undergoing authorship that is not yet complete, etc.)

accept-invalid
1SHOULD:accept-invalid SHOULD accept invalid

Conformant applications SHOULD accept data that does not meet all data constraints asserted within the profile declaring this obligation. This applies to non-valid constraints, not to non-valid syntax or failure to meet base resource validity expectations. Typically used when a system ought to be able to handle data that does not adhere to desired expectations (legacy data, test data, data undergoing authorship that is not yet complete, etc.)

accept-invalid
1SHALL:handle SHALL correctly handle

Conformant applications SHALL handle the meaning of this element correctly. Notes: this rule is vague in that doesn't specify any particular handling of the element. But it's important because an application that ignores this element is non-conformant. A good example would be a status code of 'entered-in-error' - how exactly a Resource Consumer handles this depends on the use case etc., but the application can never simply ignore such a status code. Note that whether the resource or information from it is stored for later use is irrelevant - when the resource or information in it is processed, the consequences of the element are considered. That may mean not retaining the information for later use, or informing the user, etc. Typically, this obligation marks that there are known patient safety issues that can arise if the element is ignored. Implementers should pay particular attention to the possible range of values for the element from a safety perspective.

handle
1SHOULD:handle SHOULD correctly handle

Conformant applications SHOULD handle the meaning of this element correctly. Notes: this rule is vague in that doesn't specify any particular handling of the element. But it's important because an application that ignores this element is non-conformant. A good example would be a status code of 'entered-in-error' - how exactly a Resource Consumer handles this depends on the use case etc., but the application can never simply ignore such a status code. Note that whether the resource or information from it is stored for later use is irrelevant - when the resource or information in it is processed, the consequences of the element are considered. That may mean not retaining the information for later use, or informing the user, etc. Typically, this obligation marks that there are known patient safety issues that can arise if the element is ignored. Implementers should pay particular attention to the possible range of values for the element from a safety perspective.

handle
1SHALL:display SHALL display

Conformant applications SHALL display the value of this element when presenting the data from the resource to a human user. Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource

SHALL:handle, display
1SHOULD:display SHOULD display

Conformant applications SHOULD display the value of this element when presenting the data from the resource to a human user. Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource

SHOULD:handle, display
1MAY:display MAY display

Conformant applications MAY display the value of this element when presenting the data from the resource to a human user. Notes: exactly how it is displayed is not specified, but it means that a human looking at the content of the resource is made aware of the value of the element so that they can consider the meaning of the resource

display
1SHALL:process SHALL process

Conformant applications SHALL consider the value of this element when processing the resource as specified by the IG. Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG of any ElementDefinition.valueAlternatives extensions as well as the value (or other extensions explicitly declared beneath the element in the profile containing the obligation. Examples might include consideration in decision support, consideration in claims evaluation, etc.

SHALL:handle, process
1SHOULD:process SHOULD process

Conformant applications SHOULD consider the value of this element when processing the resource as specified by the IG. Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG of any ElementDefinition.valueAlternatives extensions as well as the value (or other extensions explicitly declared beneath the element in the profile containing the obligation. Examples might include consideration in decision support, consideration in claims evaluation, etc.

SHOULD:handle, process
1MAY:process MAY process

Conformant applications MAY consider the value of this element when processing the resource as specified by the IG. Notes: this implies that the IG that specifies this obligation provides details about what processing is to be performed, and the obligation specifially relates to the processing specified in the IG of any ElementDefinition.valueAlternatives extensions as well as the value (or other extensions explicitly declared beneath the element in the profile containing the obligation. Examples might include consideration in decision support, consideration in claims evaluation, etc.

process
1SHALL:print SHALL print

Conformant applications SHALL print the value of this element somewhere. Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow

SHALL:handle, print
1SHOULD:print SHOULD print

Conformant applications SHOULD print the value of this element somewhere. Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow

SHOULD:handle, print
1MAY:print MAY print

Conformant applications MAY print the value of this element somewhere. Notes: The form of the printing is not specified. A profile using this value SHALL explain the nature of the printing requirement somehow

print
1SHALL:ignore SHALL ignore

Conformant applications SHALL not make any use of the value of this element if received.

ignore
1SHOULD:ignore SHOULD ignore

Conformant applications SHOULD not make any use of the value of this element if received.

ignore
1MAY:ignore MAY ignore

Conformant applications MAY not make any use of the value of this element if received. This is a null statement and is the default behavior or consuming systems if other obligations are not specified.

ignore
1v2-re V2 RE (required but may be empty)

RE as defined in chapter 2 of the v2 specification

SHALL:able-to-populate, SHALL:display, SHOULD:persist, SHOULD:populate, SHALL:no-error
1ihe-r2 IHE R2

R2 as defined in IHE Appendix Z

SHALL:populate, MAY:ignore, SHALL:no-error
1std Standard obligations

The standard recommended set of obligations for IGs to use unless they know they want something different. Note that the standard codes don't include use-dar, use-dar-nf, use-dar-if-allowed / use-reason - that gets put on specific elements that justify this handling

SHALL:populate, SHALL:display, SHALL:no-error