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 Restriction

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

Copyright/Legal: HL7 International

his profile sets minimum expectations for searching for and fetching information associated with a restriction. It identifies which elements, extensions, vocabularies and value sets SHALL be restricted in the Consent resource when using this profile.

Background & Scope

The FHIR specification contains a security meta tag which can be used to inform systems of the sensitivity of resources. The tag can be used by access control mechanisms to ensure content isn’t exposed inappropriately. However, the security meta tag can only indicate sensitivity at the resource level, and provides relatively little context about the restriction.

We anticipate that the operational policies and legal agreements of NDH will offer clarity regarding the data stakeholders can access. These policies, if needed, will mandate stakeholders to preserve the privacy and confidentiality of any sensitive data within local downstream environments. In order to ensure this, we have integrated this 'Restriction' profile, which is based on the 'Consent' resource. The purpose of this profile is to communicate any limitations associated with an entire specific resource instance, or certain elements of a specific resource instance for the purpose of resource instance collection or acquisition. A resource instance that contains restricted elements will always have the relevant restriction resource(s) as contained resources. However, restriction resource(s) can be queried independently of a resource instance. For instance:

The entirety of a particular women's shelter HealthcareService resource instance can be restricted. See the example below: HealthcareService/HealthcareServiceWomenShelterAll

The location and phone number of a specific women's shelter HealthcareService resource instance can be restricted. See the example below: HealthcareService/HealthcareServiceWomenShelter

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
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
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
... 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:restrictFhirPath 0..* Expression NDH usage restriction fhir path
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-restrictFhirPath
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
... scope ?!SΣ 1..1 CodeableConcept Which of the four areas this resource covers (extensible)
Binding: NDH Consent Scope Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
... category SΣ 1..* CodeableConcept describes the type of restriction (e.g. the data may be further disclosed by the downstream workflow environment per the terms of a Data Use Agreement)
Binding: NDH Consent Category Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
... dateTime SΣ 0..1 dateTime indicates when the restriction was last updated
ele-1: All FHIR elements must have a @value or children
... policy S 0..* BackboneElement Policies covered by this consent
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... uri SC 0..1 uri Specific policy covered by this restriction
ele-1: All FHIR elements must have a @value or children
... policyRule SΣC 0..1 CodeableConcept Regulation that this consents to
Binding: Consent Policy Rules Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
... provision SΣ 0..1 BackboneElement defines access rights for restricted content
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... type SΣ 0..1 code deny | permit
Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.


ele-1: All FHIR elements must have a @value or children
.... actor S 1..* BackboneElement Who|what controlled by this rule (or group, by role)
ele-1: All FHIR elements must have a @value or children
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... role S 1..1 CodeableConcept How the actor is involved
Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.


ele-1: All FHIR elements must have a @value or children
..... reference S 1..1 Reference(NDH Base CareTeam Profile | NDH Base Organization Profile | NDH Base Practitioner Profile | NDH Base PractitionerRole) definedUserOrGroup
ele-1: All FHIR elements must have a @value or children
.... action SΣ 0..1 CodeableConcept reasonType
Binding: ConsentActionCodes (extensible)
ele-1: All FHIR elements must have a @value or children
.... securityLabel SΣ 0..* Coding userType
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
.... purpose SΣ 0..* Coding reasonName
Binding: PurposeOfUse (extensible): What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.


ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Consent.statusrequiredConsentState
http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1
from the FHIR Standard
Consent.scopeextensibleConsentScopeNdhVS (a valid code from NDH ConsentScopeCodes Code System)
http://hl7.org/fhir/us/ndh/ValueSet/ConsentScopeNdhVS
from this IG
Consent.categoryextensibleConsentCategoryNdhVS (a valid code from National Healthcare Directory Consent Category Code System)
http://hl7.org/fhir/us/ndh/ValueSet/ConsentCategoryNdhVS
from this IG
Consent.policyRuleextensibleConsentPolicyRulesVS (a valid code from National Healthcare Directory ConsentPolicyRules Code System)
http://hl7.org/fhir/us/ndh/ValueSet/ConsentPolicyRulesVS
from this IG
Consent.provision.typerequiredConsentProvisionType
http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1
from the FHIR Standard
Consent.provision.actor.roleextensibleSecurityRoleType
http://hl7.org/fhir/ValueSet/security-role-type
from the FHIR Standard
Consent.provision.actionextensibleConsentActionCodes
http://hl7.org/fhir/ValueSet/consent-action
from the FHIR Standard
Consent.provision.securityLabelextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
Consent.provision.purposeextensiblePurposeOfUse
http://terminology.hl7.org/ValueSet/v3-PurposeOfUse
Consent.provision.data.meaningrequiredConsentDataMeaning
http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1
from the FHIR Standard

 

Other representations of profile: CSV, Excel, Schematron

Notes:

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
action token
actor reference
categary token
purpose token
security-lable token
scope token
status token