National Directory of Healthcare Providers & Services (NDH) Implementation Guide
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National Directory of Healthcare Providers & Services (NDH) Implementation Guide, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-ndh/ and changes regularly. See the Directory of published versions

Resource Profile: NDH Base PractitionerRole

Official URL: http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-PractitionerRole Version: 1.0.0
Standards status: Trial-use Computable Name: NdhPractitionerRole

Copyright/Legal: HL7 International

PractitionerRole typically describes details about a provider. When the provider is a practitioner, there may be a relationship to an organization. A provider renders services at a location. Practitioner participation in healthcare provider insurance networks may be direct or through their role at an organization. PractitionerRole involves either the actual or potential (hence the optionality on Practitioner) of an individual to play this role on behalf of or under the auspices of an organization. The absence of a Practitioner resource does not imply that the Organization itself is playing the role of a Practitioner, instead it implies that role has been established by the Organization and MAY apply that to a specific Practitioner.

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. PractitionerRole C 0..* USCorePractitionerRoleProfile(6.1.0) Roles/organizations the practitioner is associated with
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
pd-1: SHALL have contact information or a reference to an Endpoint
us-core-13: SHALL have a practitioner, an organization, a healthcare service, or a location.
practitioner-or-organization-or-healthcareservice-or-location: If NdhPractitionerRole.practitioner is absent ( NdhPractitionerRole.organization, NdhPractitionerRole.healthcareservice, NdhPractitionerRole.location) must be present
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:rating 0..* (Complex) NDH Rating
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-rating
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:newpatients C 0..* (Complex) New Patients
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-newpatients
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
new-patients-characteristics: If no new patients are accepted, no characteristics are allowed
.... extension:network 0..1 Reference(NDH Base Network Profile) NetworkReference
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-network-reference
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:usage-restriction 0..* Reference(NDH Base Restriction) {c} Usage Restriction
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-usage-restriction
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:digitalcertificate 0..* (Complex) Digital Certificate
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-digitalcertificate
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:qualification 0..* (Complex) Qualification
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:verification-status 0..1 CodeableConcept NDH Verification Status
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-verification-status
Binding: NDH Verification Status Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... Slices for extension Content/Rules for all slices
..... extension:identifier-status 0..1 code NDH Identifier Status
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-identifier-status
Binding: Identifier Status Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
.... assigner Σ 0..1 Reference(NDH Base Organization Profile) Organization that issued id (may be just text)
ele-1: All FHIR elements must have a @value or children
... active Σ 1..1 boolean Whether this practitioner role record is in active use
ele-1: All FHIR elements must have a @value or children
Required Pattern: true
... practitioner SΣC 0..1 Reference(NDH Base Practitioner Profile) Practitioner that is able to provide the defined services for the organization
ele-1: All FHIR elements must have a @value or children
... organization SΣC 0..1 Reference(NDH Base Organization Profile) Organization where the role is available
ele-1: All FHIR elements must have a @value or children
... Slices for code SΣ 0..* CodeableConcept Roles which this practitioner may perform
Slice: Unordered, Open by value:$this
Binding: Care Team Member Function . (extensible): Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.


ele-1: All FHIR elements must have a @value or children
.... code:NDHPractitionerRoleCode SΣ 0..* CodeableConcept NDH PractitionerRole Code
Binding: PractitionerRole Code Value Set (required)
ele-1: All FHIR elements must have a @value or children
... specialty SΣ 0..* CodeableConcept Specific specialty of the practitioner
Binding: Individual and Group Specialties (extensible)
ele-1: All FHIR elements must have a @value or children
... location SΣC 0..* Reference(NDH Base Location Profile) The location(s) at which this practitioner provides care
ele-1: All FHIR elements must have a @value or children
... healthcareService SC 0..* Reference(NDH Base HealthcareService Profile) The list of healthcare services that this worker provides for this role's Organization/Location(s)
ele-1: All FHIR elements must have a @value or children
... telecom SΣC 0..* ContactPoint Contact details that are specific to the role/location/service
ele-1: All FHIR elements must have a @value or children
.... Slices for extension Content/Rules for all slices
..... extension:contactpoint-availabletime 0..* (Complex) NDH Contactpoint Availabletime
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-contactpoint-availabletime
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... extension:via-intermediary 0..1 Reference(NDH Base PractitionerRole | NDH Base OrganizationAffiliation Profile | NDH Base Location Profile | NDH Base Organization Profile) Via Intermediary
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-via-intermediary
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... system SΣC 1..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.


ele-1: All FHIR elements must have a @value or children
.... value SΣ 1..1 string The actual contact point details
ele-1: All FHIR elements must have a @value or children
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.


ele-1: All FHIR elements must have a @value or children
... endpoint SC 0..* Reference(NDH Base Endpoint Profile) Technical endpoints providing access to services operated for the practitioner with this role
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
PractitionerRole.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
PractitionerRole.codeextensibleCareTeamMemberFunction .
http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.30
PractitionerRole.code:NDHPractitionerRoleCoderequiredPractitionerRoleVS (a valid code from Practitioner Role Codes Code System)
http://hl7.org/fhir/us/ndh/ValueSet/PractitionerRoleVS
from this IG
PractitionerRole.specialtyextensibleIndividualAndGroupSpecialtiesVS
http://hl7.org/fhir/us/ndh/ValueSet/IndividualAndGroupSpecialtiesVS
from this IG
PractitionerRole.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
PractitionerRole.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
practitioner-or-organization-or-healthcareservice-or-locationerrorPractitionerRoleIf NdhPractitionerRole.practitioner is absent ( NdhPractitionerRole.organization, NdhPractitionerRole.healthcareservice, NdhPractitionerRole.location) must be present
: practitioner.exists() or (organization.exists() or healthcareService.exists() or location.exists())

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Search Parameters

Search Parameter defined by the NDH IG

SearchParameter Name Type Example
location reference GET [base]/PractitionerRole?location.address-state=FL
network reference GET [base]/PractitionerRole?network.type=ntwk$network.name=Florida Blue
new-patient token GET [base]/PractitionerRole?new-patient=newpt
new-patient-from-network reference GET [base]/PractitionerRole?new-patient-from-network=newpt
organization reference GET [base]/PractitionerRole?organization.name=Florida Blue
verification-status token GET [base]/PractitionerRole?verification-status=complete

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.

SearchParameter Name Type Example
active token GET [base]/PractitionerRole?active=true
endpoint reference GET [base]/PractitionerRole?endpoint.status=active
identifier token GET [base]/PractitionerRole?identifier=1234567
practitioner reference GET [base]/PractitionerRole?practitoner.name=Joe Smith
role token GET [base]/PractitionerRole?role=att
service reference GET [base]/PractitionerRole?service.address-state=FL
specialty token GET [base]/PractitionerRole?specialty=103TF0000X

_include Search Parameter

_include Example
PractitionerRole:endpoint GET [base]/PractitionerRole?_include=PractitionerRole:endpoint
PractitionerRole:location GET [base]/PractitionerRole?_include=PractitionerRole:location
PractitionerRole:network GET [base]/PractitionerRole?_include=PractitionerRole:network
PractitionerRole:new-patient-from-network GET [base]/PractitionerRole?_include= PractitionerRole:new-patient-from-network
PractitionerRole:organization GET [base]/PractitionerRole?_include=PractitionerRole:organization
PractitionerRole:practitioner GET [base]/PractitionerRole?_include=PractitionerRole:practitioner
PractitionerRole:service GET [base]/PractitionerRole?_include=PractitionerRole:service

_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.

The reason the cardinality of PractitionerRole.network is 0..1

The network cardinality sets to 0..1 is to meet the requirements of linking PractitionerRole with a specific time period. The duration a practitioner spends in a network often differs across networks, and it's unusual for these periods to coincide. When a Practitioner is incorporated into a new network, the relevant time frame adheres to that specific network's agreement or contract with the practitioner. The same principle applies when the practitioner departs from the network.

How resource ownership functions when multiple entities can provide information for the same resource

Assuming that the Practitioner "owns" the practitionerRole, the practitioner must attest to the information related to their participation in a specific network. If there is no existing network declaration associated with that practitionerRole, the practitioner should update the practitionerRole accordingly. However, if a network declaration already exists for that role, the practitioner should create a new practitionerRole and include the network information in this role. This process is also applicable to other individuals who have ownership responsibilities for the practitionerRole.

PractitionerRole.availabeTime and PractitionerRole.notAvailable

Given that both 'availableTime' and 'notAvailable' time are optional elements, they can be excluded for intricate or often changing schedules. These fundamental elements are designed for use where providers have fairly stable schedules (such as clinic schedules that need to be communicated clearly as part of the directory resources), as opposed to an on-call practitioner's schedule.

PractitionerRole, Location, Address

The address for a practitionerRole should be located on the Location reference. There is no address on the practitionerRole base resource since the location reference of practitionerRole has an address that should be used by the practitioner as part of their role. Each practitionerRole can support multiple locations. If two practitioners work at the same facility and each of them has their own non-service delivery locations, in addition to the common service delivery location. The guidance descripted in the diagram below:

PractitionerRole /PractitionerAPractitionerRole /PractitionerBPractitioner /PractitionerA (Practitioners may have their own work addresseswhich are not related to any practitionerRoles.For those usecases, the Practitioner.address should be used)Location /LocationAB.name = AB Clinic.address = Office 200.address.use = work.type = Outpatient facilityLcation /LocationA2.name = Office of Practitioner A.address = Office 200 Suite A.address.use = workno value in .typePractitioner /PractitionerB (Practitioners may have their own work addresseswhich are not related to any practitionerRolesFor those usecases, the Practitioner.address should be used)Location /LocationB2.name = Office of Practitioner B.address = Office 200 Suite B.address.use = workno value in .typepractitioner 0..1location[1]location[2]practitioner 0..1location[1]location[2]