Background & Scope

OrganizationAffiliation resource is designed to outline connections between multiple organizations. This includes details on the services provided by one organization to another, the location(s) where services are available, the electronic endpoints used, and other relevant information.

OrganizationAffiliation is useful for defining relationships between organizations that do not have a hierarchical structure. For instance:

• One organization may provide services to another organization
• Two or more organizations may collaborate in a partnership or joint venture
• An organization may be a member of another organization, without being owned by it (for example, a hospital can be a member of the American Hospital Association or a health information exchange network).

OrganizationAffiliation and practitionerRole share a similar structure. However, while practitionerRole references both practitioner and organization, OrganizationAffiliation involves references to a participatingOrg and an organization. The participating organization provides "services" to the primary organization, just as a practitioner provides services to an organization. To illustrate this, here are examples for the three cases mentioned earlier:

The participating organization provides services to the primary organization. In a joint venture, the joint venture itself is the primary organization, while partners within the joint venture are considered participating organizations. This requires two instances of the OrganizationAffiliation resource. In an association, the association is the primary organization, and its members are participating organizations. Additionally, OrganizationAffiliation is used to indicate when an organization provides services for a health insurance provider network.

Each instance has its own time period and can optionally include links to specific related services or locations that are accessible. These referenced locations or services should be associated with the participating organization and may available to the primary organization.

An OrganizationAffiliation role could encompass various healthcare services at multiple locations. When different locations provide distinct services, it is recommended to employ multiple OrganizationAffiliation resources and to separate them by location.

To associate an organization to an active network, it could be achieved by modifying the OrganizationAffiliation.period or for the organization. To change a network, it is necessary to create a new OrganizationAffiliation.

An organization has the capability to be affiliated with multiple networks. However, to ensure clarity and avoid confusion, it is recommended that each OrganizationAffiliation corresponds to only one network, even if the affiliations occur at different times.

Search Parameters

Search Parameter defined by the NDH IG

Search Parameter defined by FHIR Search Parameter Registry and used by the NDH IG

Since there is no direct individual url for each Search Parameter defined by FHIR Serach Parameter Registry, we have provided the following links for you to access more information about them.

• Search Parameter Registry
• OrganizationAffiliation Search Parameter from Registry

_include Search Parameter

_revinclude Search Parameter

None

Special Search Parameters

The search parameters outlined above are straightforward for basic scenarios but have limitations in handling complex combination queries. To enhance these capabilities, employing the special search parameters _filter is recommended.

Why is the Qualification Extension Needed in Organization Affiliation?

The qualification extension in the OrganizationAffiliation Resource is significant as it offers a valid use case in real-world practice. For instance, an oncology group seeking privileges to practice in a hospital setting typically requires various approvals and certifications. This includes each physician in the group being licensed to practice medicine in the state where the hospital is located. Additionally, each physician must apply for and be granted the privilege to practice at the specific hospital. Furthermore, the oncology practice itself may also seek accreditation from organizations such as the Commission on Cancer (CoC) or the Quality Oncology Practice Initiative (QOPI), which can bolster its reputation and demonstrate a commitment to quality care. The qualifications of the oncology practice reflect its specific credential to the hospital where they practice. Although these qualifications can be documented in the oncology practice organization resource, an organization may have several qualifications, of which only certain ones are relevant to a specific practice setting. Therefore, it is necessary for both the OrganizationAffiliation Resource and the Organization Resource to include a qualification extension that serves different functions across various contexts.

Search

Search OrganizationAffiliation resource based on the role of the participatingOrganization: Get [base]/OrganizationAffiliation?code=HieInitiator

Search OrganizationAffiliation resources which have participatingOrganization present: Get [base]/OrganizationAffiliation?_include=OrganizationAffiliation:participatingOrganization

Search Organization resource which associate with OrganizationAffiliation: Get [base]/Organization?_revinclude=OrganizationAffiliation:participatingOrganization