PACIO Advance Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-pacio-adi/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: ADI Participant Consent

This profile is used to represent a consent for an advance directive participant such as a healthcare agent or advisor and power or limitation granted to such persons.

Usage:

• Refer to this Resource Profile: ADI PtAuthored Composition and ADI PMO Composition
• Examples for this Resource Profile: Consent/Example-McBee-HealthcareAgentConsent and Consent/Example-Smith-Johnson-HealthcareAgentConsent

Formal Views of Profile Content

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

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

This structure is derived from Consent

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time HCA-authority-scope-provisionType: Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist HCA-consent-category: Category must have a ConsentCategory of 'acd' HCA-provision-purpose: Provision purpose must have a purpose of 'PWATRNY'
text	S	1..1	Narrative	Text summary of the resource, for human interpretation
status	S	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Required Pattern: active
scope		1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: Healthcare Agent Powers or Limitations Indicator (required)
category	S	1..1	CodeableConcept	Classification of the consent statement - for indexing/retrieval Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: acd
patient	S	1..1	Reference(US Core Patient Profile)	Who the consent applies to
dateTime	S	0..1	dateTime	When this Consent was created or indexed
policy	S	0..*	BackboneElement	Policies covered by this consent
provision	S	1..1	BackboneElement	Constraints to the base Consent.policyRule
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
type	S	1..1	code	deny | permit
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
role		1..1	CodeableConcept	How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference		1..1	Reference(ADI Participant)	Resource for the actor (or group, by role)
action		0..*	CodeableConcept	Actions controlled by this rule Binding: Healthcare Agent Decisions (extensible)
purpose		0..*	Coding	Context of activities covered by this rule Binding: v3 Code System ActReason (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Consent.scope	required	HealthcareAgentPowersOrLimitationsIndicator http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.13 from https://vsac.nlm.nih.gov
Consent.provision.actor.role	required	HealthcareAgentOrProxyChoices http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35 from https://vsac.nlm.nih.gov
Consent.provision.action	extensible	ADIHCADecisionsVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADIHCADecisionsVS from this IG
Consent.provision.purpose	required	ActReason http://terminology.hl7.org/ValueSet/v3-ActReason

Constraints

Id	Grade	Path(s)	Details	Requirements
HCA-authority-scope-provisionType	error	Consent	Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist : (scope.coding.where(code = '75786-4').exists() and provision.type = 'permit') or (scope.coding.where(code = '81346-9').exists() and provision.type = 'deny') or (scope.coding.where(code = '81335-2').exists() and provision.type.exists().not() and provision.action.exists().not() and provision.provision.exists().not())
HCA-consent-category	error	Consent	Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists()
HCA-provision-purpose	error	Consent	Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists()

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time ppc-1: Either a Policy or PolicyRule ppc-2: IF Scope=privacy, there must be a patient ppc-3: IF Scope=research, there must be a patient ppc-4: IF Scope=adr, there must be a patient ppc-5: IF Scope=treatment, there must be a patient HCA-authority-scope-provisionType: Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist HCA-consent-category: Category must have a ConsentCategory of 'acd' HCA-provision-purpose: Provision purpose must have a purpose of 'PWATRNY'
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	1..1	Narrative	Text summary of the resource, for human interpretation
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent. Required Pattern: active
scope	?!Σ	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: Healthcare Agent Powers or Limitations Indicator (required)
category	SΣ	1..1	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: acd
patient	SΣ	1..1	Reference(US Core Patient Profile)	Who the consent applies to
dateTime	SΣ	0..1	dateTime	When this Consent was created or indexed
policy	S	0..*	BackboneElement	Policies covered by this consent
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
provision	SΣ	1..1	BackboneElement	Constraints to the base Consent.policyRule
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	code	deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role		1..1	CodeableConcept	How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference		1..1	Reference(ADI Participant)	Resource for the actor (or group, by role)
action	Σ	0..*	CodeableConcept	Actions controlled by this rule Binding: Healthcare Agent Decisions (extensible)
purpose	Σ	0..*	Coding	Context of activities covered by this rule Binding: v3 Code System ActReason (required)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Consent.status	required	Pattern: active http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 from the FHIR Standard
Consent.scope	required	HealthcareAgentPowersOrLimitationsIndicator http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.13 from https://vsac.nlm.nih.gov
Consent.category	extensible	Pattern: acd http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.provision.type	required	ConsentProvisionType http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1 from the FHIR Standard
Consent.provision.actor.role	required	HealthcareAgentOrProxyChoices http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35 from https://vsac.nlm.nih.gov
Consent.provision.action	extensible	ADIHCADecisionsVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADIHCADecisionsVS from this IG
Consent.provision.purpose	required	ActReason http://terminology.hl7.org/ValueSet/v3-ActReason

Constraints

Id	Grade	Path(s)	Details	Requirements
HCA-authority-scope-provisionType	error	Consent	Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist : (scope.coding.where(code = '75786-4').exists() and provision.type = 'permit') or (scope.coding.where(code = '81346-9').exists() and provision.type = 'deny') or (scope.coding.where(code = '81335-2').exists() and provision.type.exists().not() and provision.action.exists().not() and provision.provision.exists().not())
HCA-consent-category	error	Consent	Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists()
HCA-provision-purpose	error	Consent	Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists()

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time ppc-1: Either a Policy or PolicyRule ppc-2: IF Scope=privacy, there must be a patient ppc-3: IF Scope=research, there must be a patient ppc-4: IF Scope=adr, there must be a patient ppc-5: IF Scope=treatment, there must be a patient HCA-authority-scope-provisionType: Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist HCA-consent-category: Category must have a ConsentCategory of 'acd' HCA-provision-purpose: Provision purpose must have a purpose of 'PWATRNY'
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	1..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier for this record (external references) Example General: {"system":"http://acme.org/identifier/local/eCMS","value":"Local eCMS identifier"}
status	?!SΣ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent. Required Pattern: active
scope	?!Σ	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: Healthcare Agent Powers or Limitations Indicator (required)
category	SΣ	1..1	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: acd
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
patient	SΣ	1..1	Reference(US Core Patient Profile)	Who the consent applies to
dateTime	SΣ	0..1	dateTime	When this Consent was created or indexed
performer	Σ	0..*	Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)	Who is agreeing to the policy and rules
organization	Σ	0..*	Reference(Organization)	Custodian of the consent
source[x]	Σ	0..1		Source from which this consent is taken
sourceAttachment			Attachment
sourceReference			Reference(Consent | DocumentReference | Contract | QuestionnaireResponse)
policy	S	0..*	BackboneElement	Policies covered by this consent
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
authority	C	0..1	uri	Enforcement source for policy
uri	C	0..1	uri	Specific policy covered by this consent
policyRule	ΣC	0..1	CodeableConcept	Regulation that this consents to Binding: ConsentPolicyRuleCodes (extensible): Regulatory policy examples.
verification	Σ	0..*	BackboneElement	Consent Verified by patient or family
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
verified	Σ	1..1	boolean	Has been verified
verifiedWith		0..1	Reference(Patient | RelatedPerson)	Person who verified
verificationDate		0..1	dateTime	When consent verified
provision	SΣ	1..1	BackboneElement	Constraints to the base Consent.policyRule
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	code	deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
period	Σ	0..1	Period	Timeframe for this rule
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role		1..1	CodeableConcept	How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference		1..1	Reference(ADI Participant)	Resource for the actor (or group, by role)
action	Σ	0..*	CodeableConcept	Actions controlled by this rule Binding: Healthcare Agent Decisions (extensible)
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities covered by this rule Binding: v3 Code System ActReason (required)
class	Σ	0..*	Coding	e.g. Resource Type, Profile, CDA, etc. Binding: ConsentContentClass (extensible): The class (type) of information a consent rule covers.
code	Σ	0..*	CodeableConcept	e.g. LOINC or SNOMED CT code, etc. in the content Binding: ConsentContentCodes (example): If this code is found in an instance, then the exception applies.
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this rule
data	Σ	0..*	BackboneElement	Data controlled by this rule
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions.
reference	Σ	1..1	Reference(Resource)	The actual data reference
provision		0..*	See provision (Consent)	Nested Exception Rules
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Consent.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Consent.status	required	Pattern: active http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 from the FHIR Standard
Consent.scope	required	HealthcareAgentPowersOrLimitationsIndicator http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.13 from https://vsac.nlm.nih.gov
Consent.category	extensible	Pattern: acd http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.policyRule	extensible	ConsentPolicyRuleCodes http://hl7.org/fhir/ValueSet/consent-policy from the FHIR Standard
Consent.provision.type	required	ConsentProvisionType http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1 from the FHIR Standard
Consent.provision.actor.role	required	HealthcareAgentOrProxyChoices http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35 from https://vsac.nlm.nih.gov
Consent.provision.action	extensible	ADIHCADecisionsVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADIHCADecisionsVS from this IG
Consent.provision.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.provision.purpose	required	ActReason http://terminology.hl7.org/ValueSet/v3-ActReason
Consent.provision.class	extensible	ConsentContentClass http://hl7.org/fhir/ValueSet/consent-content-class from the FHIR Standard
Consent.provision.code	example	ConsentContentCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/consent-content-code from the FHIR Standard
Consent.provision.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
HCA-authority-scope-provisionType	error	Consent	Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist : (scope.coding.where(code = '75786-4').exists() and provision.type = 'permit') or (scope.coding.where(code = '81346-9').exists() and provision.type = 'deny') or (scope.coding.where(code = '81335-2').exists() and provision.type.exists().not() and provision.action.exists().not() and provision.provision.exists().not())
HCA-consent-category	error	Consent	Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists()
HCA-provision-purpose	error	Consent	Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists()

This structure is derived from Consent

Summary

Mandatory: 5 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• ADI Participant (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Participant)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

Differential View

This structure is derived from Consent

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time HCA-authority-scope-provisionType: Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist HCA-consent-category: Category must have a ConsentCategory of 'acd' HCA-provision-purpose: Provision purpose must have a purpose of 'PWATRNY'
text	S	1..1	Narrative	Text summary of the resource, for human interpretation
status	S	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Required Pattern: active
scope		1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: Healthcare Agent Powers or Limitations Indicator (required)
category	S	1..1	CodeableConcept	Classification of the consent statement - for indexing/retrieval Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: acd
patient	S	1..1	Reference(US Core Patient Profile)	Who the consent applies to
dateTime	S	0..1	dateTime	When this Consent was created or indexed
policy	S	0..*	BackboneElement	Policies covered by this consent
provision	S	1..1	BackboneElement	Constraints to the base Consent.policyRule
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
type	S	1..1	code	deny | permit
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
role		1..1	CodeableConcept	How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference		1..1	Reference(ADI Participant)	Resource for the actor (or group, by role)
action		0..*	CodeableConcept	Actions controlled by this rule Binding: Healthcare Agent Decisions (extensible)
purpose		0..*	Coding	Context of activities covered by this rule Binding: v3 Code System ActReason (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Consent.scope	required	HealthcareAgentPowersOrLimitationsIndicator http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.13 from https://vsac.nlm.nih.gov
Consent.provision.actor.role	required	HealthcareAgentOrProxyChoices http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35 from https://vsac.nlm.nih.gov
Consent.provision.action	extensible	ADIHCADecisionsVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADIHCADecisionsVS from this IG
Consent.provision.purpose	required	ActReason http://terminology.hl7.org/ValueSet/v3-ActReason

Constraints

Id	Grade	Path(s)	Details	Requirements
HCA-authority-scope-provisionType	error	Consent	Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist : (scope.coding.where(code = '75786-4').exists() and provision.type = 'permit') or (scope.coding.where(code = '81346-9').exists() and provision.type = 'deny') or (scope.coding.where(code = '81335-2').exists() and provision.type.exists().not() and provision.action.exists().not() and provision.provision.exists().not())
HCA-consent-category	error	Consent	Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists()
HCA-provision-purpose	error	Consent	Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time ppc-1: Either a Policy or PolicyRule ppc-2: IF Scope=privacy, there must be a patient ppc-3: IF Scope=research, there must be a patient ppc-4: IF Scope=adr, there must be a patient ppc-5: IF Scope=treatment, there must be a patient HCA-authority-scope-provisionType: Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist HCA-consent-category: Category must have a ConsentCategory of 'acd' HCA-provision-purpose: Provision purpose must have a purpose of 'PWATRNY'
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
text	S	1..1	Narrative	Text summary of the resource, for human interpretation
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent. Required Pattern: active
scope	?!Σ	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: Healthcare Agent Powers or Limitations Indicator (required)
category	SΣ	1..1	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
code		1..1	code	Symbol in syntax defined by the system Fixed Value: acd
patient	SΣ	1..1	Reference(US Core Patient Profile)	Who the consent applies to
dateTime	SΣ	0..1	dateTime	When this Consent was created or indexed
policy	S	0..*	BackboneElement	Policies covered by this consent
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
provision	SΣ	1..1	BackboneElement	Constraints to the base Consent.policyRule
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	code	deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role		1..1	CodeableConcept	How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference		1..1	Reference(ADI Participant)	Resource for the actor (or group, by role)
action	Σ	0..*	CodeableConcept	Actions controlled by this rule Binding: Healthcare Agent Decisions (extensible)
purpose	Σ	0..*	Coding	Context of activities covered by this rule Binding: v3 Code System ActReason (required)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Consent.status	required	Pattern: active http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 from the FHIR Standard
Consent.scope	required	HealthcareAgentPowersOrLimitationsIndicator http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.13 from https://vsac.nlm.nih.gov
Consent.category	extensible	Pattern: acd http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.provision.type	required	ConsentProvisionType http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1 from the FHIR Standard
Consent.provision.actor.role	required	HealthcareAgentOrProxyChoices http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35 from https://vsac.nlm.nih.gov
Consent.provision.action	extensible	ADIHCADecisionsVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADIHCADecisionsVS from this IG
Consent.provision.purpose	required	ActReason http://terminology.hl7.org/ValueSet/v3-ActReason

Constraints

Id	Grade	Path(s)	Details	Requirements
HCA-authority-scope-provisionType	error	Consent	Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist : (scope.coding.where(code = '75786-4').exists() and provision.type = 'permit') or (scope.coding.where(code = '81346-9').exists() and provision.type = 'deny') or (scope.coding.where(code = '81335-2').exists() and provision.type.exists().not() and provision.action.exists().not() and provision.provision.exists().not())
HCA-consent-category	error	Consent	Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists()
HCA-provision-purpose	error	Consent	Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time ppc-1: Either a Policy or PolicyRule ppc-2: IF Scope=privacy, there must be a patient ppc-3: IF Scope=research, there must be a patient ppc-4: IF Scope=adr, there must be a patient ppc-5: IF Scope=treatment, there must be a patient HCA-authority-scope-provisionType: Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist HCA-consent-category: Category must have a ConsentCategory of 'acd' HCA-provision-purpose: Provision purpose must have a purpose of 'PWATRNY'
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text	S	1..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifier for this record (external references) Example General: {"system":"http://acme.org/identifier/local/eCMS","value":"Local eCMS identifier"}
status	?!SΣ	1..1	code	draft | proposed | active | rejected | inactive | entered-in-error Binding: ConsentState (required): Indicates the state of the consent. Required Pattern: active
scope	?!Σ	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: Healthcare Agent Powers or Limitations Indicator (required)
category	SΣ	1..1	CodeableConcept	Classification of the consent statement - for indexing/retrieval Binding: ConsentCategoryCodes (extensible): A classification of the type of consents found in a consent statement. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/consentcategorycodes
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: acd
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
patient	SΣ	1..1	Reference(US Core Patient Profile)	Who the consent applies to
dateTime	SΣ	0..1	dateTime	When this Consent was created or indexed
performer	Σ	0..*	Reference(Organization | Patient | Practitioner | RelatedPerson | PractitionerRole)	Who is agreeing to the policy and rules
organization	Σ	0..*	Reference(Organization)	Custodian of the consent
source[x]	Σ	0..1		Source from which this consent is taken
sourceAttachment			Attachment
sourceReference			Reference(Consent | DocumentReference | Contract | QuestionnaireResponse)
policy	S	0..*	BackboneElement	Policies covered by this consent
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
authority	C	0..1	uri	Enforcement source for policy
uri	C	0..1	uri	Specific policy covered by this consent
policyRule	ΣC	0..1	CodeableConcept	Regulation that this consents to Binding: ConsentPolicyRuleCodes (extensible): Regulatory policy examples.
verification	Σ	0..*	BackboneElement	Consent Verified by patient or family
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
verified	Σ	1..1	boolean	Has been verified
verifiedWith		0..1	Reference(Patient | RelatedPerson)	Person who verified
verificationDate		0..1	dateTime	When consent verified
provision	SΣ	1..1	BackboneElement	Constraints to the base Consent.policyRule
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	code	deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
period	Σ	0..1	Period	Timeframe for this rule
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
ClauseExtension		0..*	(Complex)	Clause URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role		1..1	CodeableConcept	How the actor is involved Binding: Healthcare Agent or Proxy Choices (required)
reference		1..1	Reference(ADI Participant)	Resource for the actor (or group, by role)
action	Σ	0..*	CodeableConcept	Actions controlled by this rule Binding: Healthcare Agent Decisions (extensible)
securityLabel	Σ	0..*	Coding	Security Labels that define affected resources Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	Σ	0..*	Coding	Context of activities covered by this rule Binding: v3 Code System ActReason (required)
class	Σ	0..*	Coding	e.g. Resource Type, Profile, CDA, etc. Binding: ConsentContentClass (extensible): The class (type) of information a consent rule covers.
code	Σ	0..*	CodeableConcept	e.g. LOINC or SNOMED CT code, etc. in the content Binding: ConsentContentCodes (example): If this code is found in an instance, then the exception applies.
dataPeriod	Σ	0..1	Period	Timeframe for data controlled by this rule
data	Σ	0..*	BackboneElement	Data controlled by this rule
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
meaning	Σ	1..1	code	instance | related | dependents | authoredby Binding: ConsentDataMeaning (required): How a resource reference is interpreted when testing consent restrictions.
reference	Σ	1..1	Reference(Resource)	The actual data reference
provision		0..*	See provision (Consent)	Nested Exception Rules
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Consent.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Consent.status	required	Pattern: active http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 from the FHIR Standard
Consent.scope	required	HealthcareAgentPowersOrLimitationsIndicator http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.13 from https://vsac.nlm.nih.gov
Consent.category	extensible	Pattern: acd http://hl7.org/fhir/ValueSet/consent-category from the FHIR Standard
Consent.policyRule	extensible	ConsentPolicyRuleCodes http://hl7.org/fhir/ValueSet/consent-policy from the FHIR Standard
Consent.provision.type	required	ConsentProvisionType http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1 from the FHIR Standard
Consent.provision.actor.role	required	HealthcareAgentOrProxyChoices http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1046.35 from https://vsac.nlm.nih.gov
Consent.provision.action	extensible	ADIHCADecisionsVS http://hl7.org/fhir/us/pacio-adi/ValueSet/ADIHCADecisionsVS from this IG
Consent.provision.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Consent.provision.purpose	required	ActReason http://terminology.hl7.org/ValueSet/v3-ActReason
Consent.provision.class	extensible	ConsentContentClass http://hl7.org/fhir/ValueSet/consent-content-class from the FHIR Standard
Consent.provision.code	example	ConsentContentCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/consent-content-code from the FHIR Standard
Consent.provision.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
HCA-authority-scope-provisionType	error	Consent	Scope indicates powers granted and provision type is permit or scope indicates limitations placed and provision type is deny or scope indicates no powers/limitations and no provisions type and no action exist : (scope.coding.where(code = '75786-4').exists() and provision.type = 'permit') or (scope.coding.where(code = '81346-9').exists() and provision.type = 'deny') or (scope.coding.where(code = '81335-2').exists() and provision.type.exists().not() and provision.action.exists().not() and provision.provision.exists().not())
HCA-consent-category	error	Consent	Category must have a ConsentCategory of 'acd' : category.coding.where(code = 'acd').exists()
HCA-provision-purpose	error	Consent	Provision purpose must have a purpose of 'PWATRNY' : provision.purpose.exists().not() or provision.purpose.where(code = 'PWATRNY').exists()

This structure is derived from Consent

Summary

Mandatory: 5 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• ADI Participant (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-Participant)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-clause-extension

Other representations of profile: CSV, Excel, Schematron