Generated Narrative: StructureDefinition ndh-PractitionerRole Name Flags Card. Type Description & Constraints PractitionerRole <a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;; padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R4/conformance-rules.html#constraints" title="This element has or is affected by constraints ( practitioner-or-organization-or-healthcareservice-or-location )">C 0..* USCorePractitionerRoleProfile(6.1.0) Roles/organizations the practitioner is associated with Constraints: practitioner-or-organization-or-healthcareservice-or-location #xD; meta #xD; lastUpdated 1..1 instant When the resource version last changed #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:rating 0..* (Complex) NDH Rating URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-rating #xD; extension:newpatients S 0..* (Complex) New Patients URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-newpatients #xD; extension:network 0..* Reference(NDH Network Profile) NetworkReference URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-network-reference #xD; extension:qualification 0..* (Complex) Qualification URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification #xD; 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) #xD; identifier S 0..* Identifier Business Identifiers that are specific to a role/location #xD; Slices for extension Content/Rules for all slices #xD; 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) #xD; assigner 0..1 Reference(NDH Organization Profile) Organization that issued id (may be just text) #xD; active 1..1 boolean Whether this practitioner role record is in active use Required Pattern: true #xD; period 0..1 Period The period during which the practitioner is authorized to perform in these role(s) #xD; practitioner 0..1 Reference(NDH Practitioner Profile) Practitioner that is able to provide the defined services for the organization #xD; organization 0..1 Reference(NDH Organization Profile) Organization where the role is available #xD; Slices for code 0..* CodeableConcept Roles which this practitioner may perform Slice: Unordered, Open by value:$this #xD; code:NDHPractitionerRoleCode 0..* CodeableConcept NDH PractitionerRole Code Binding: PractitionerRole Code Value Set (required) #xD; specialty 0..* CodeableConcept Specific specialty of the practitioner Binding: Individual Qualifications Value Set (extensible) #xD; location 0..* Reference(NDH Location Profile) The location(s) at which this practitioner provides care #xD; healthcareService S 0..* Reference(NDH HealthcareService Profile) The list of healthcare services that this worker provides for this role's Organization/Location(s) #xD; telecom 0..* ContactPoint Contact details that are specific to the role/location/service #xD; Slices for extension Content/Rules for all slices #xD; extension:contactpoint-availabletime 0..* (Complex) NDH Contact Point Available Time URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-contactpoint-availabletime #xD; extension:via-intermediary 0..1 Reference(NDH PractitionerRole | NDH OrganizationAffiliation Profile | NDH Location Profile | NDH Organization Profile) Via Intermediary URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-via-intermediary #xD; availableTime 0..* BackboneElement Times the Service Site is available #xD; notAvailable 0..* BackboneElement Not available during this time due to provided reason #xD; endpoint 0..* Reference(NDH Endpoint Profile) Technical endpoints providing access to services operated for the practitioner with this role #xD; Documentation for this format
HL7 International / Patient Administration
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.
NDH to Plan-Net PractitionerRole Mapping
Maps NDH PractitionerRole profile to the Plan-Net PractitionerRole profile, noting elements not present in Plan-Net.
Roles/organizations the practitioner is associated with
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
SHALL have contact information or a reference to an Endpoint
SHALL have a practitioner, an organization, a healthcare service, or a location.
practitioner or organization or healthcareService or location
exists(f:practitioner) or exists(f:organization) or exists(f:healthcareService) or exists(f:location)
If NdhPractitionerRole.practitioner is absent ( NdhPractitionerRole.organization, NdhPractitionerRole.healthcareservice, NdhPractitionerRole.location) must be present
practitioner.exists() or (organization.exists() or healthcareService.exists() or location.exists())
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
When the resource last changed - e.g. when the version changed.
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R4/http.html#read) interaction.
Identifies where the resource comes from
A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Security Labels from the Healthcare Privacy and Security Classification System.
Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
New Patients indicates whether new patients are being accepted in general, or from a specific network. This extension is included in the PractitionerRole, HealthcareService, and Location profiles. This provides needed flexibility for specifying whether a provider accepts new patients by location and network.
If no new patients are accepted, no characteristics are allowed
extension('http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-newpatients').value.coding.exists(code = 'nopt') implies extension('http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-newpatients-characteristics').empty()
A reference to the healthcare provider insurance networks (NdhNetwork) the practitioner participates in through their role
An extension to add qualifications for an organization (e.g. accreditation) or practitionerRole (e.g. registered to prescribe controlled substances).
Indicates a resource instance verification status
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Business Identifiers that are specific to a role/location
Business Identifiers that are specific to a role/location.
Often, specific identities are assigned for the agent.
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Identifier.system is always case sensitive.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Time period when id is/was valid for use
Time period during which identifier is/was valid for use.
Role.effectiveTime or implied by context
Organization that issued id (may be just text)
Organization that issued/manages the identifier.
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Whether this practitioner role record is in active use
Whether this practitioner role record is in active use.
If this value is false, you may refer to the period to see when the role was in active use. If there is no period specified, no inference can be made about when it was active.
Need to be able to mark a practitioner role record as not to be used because it was created in error, or otherwise no longer in active use.
This resource is generally assumed to be active if no value is provided for the active element
The period during which the practitioner is authorized to perform in these role(s)
The period during which the person is authorized to act as a practitioner in these role(s) for the organization.
Even after the agencies is revoked, the fact that it existed must still be recorded.
.performance[@typeCode <= 'PPRF'].ActDefinitionOrEvent.effectiveTime
(ServD maps Practitioners and Organizations via another entity, so this concept is not available)
Practitioner that is able to provide the defined services for the organization
Practitioner that is able to provide the defined services for the organization.
Organization where the role is available
The organization where this role is available
Some relationships (represented as PractitionerRoles) that may exist between practitioners and organizations include: - A practitioner may act as a pediatrician when associated with an organization that runs a family clinic. PractitionerRole.organization would represent the family clinic. - The same practitioner may act as a physician when providing physicals for an athletics department at a school. PractitionerRole.organization would represent the school. - A practitioner may perform coumadin anticoagulation services for a clinic run by a health system. PractitionerRole.organization would represent the coumadin clinic. - A practitioner may act as an inpatient pharmacist reviewing and dispensing medications. PractitionerRole.organization would represent the hospital pharmacy. - A practitioner may perform medication management and adherence services for an internal medicine clinic. PractitionerRole.organization would represent the internal medicine clinic. - A practitioner is part of a payer's network such as a preferred provider organization (PPO), or health maintenance organizations (HMO)). PractitionerRole.organization would represent the payer's network. Each of the examples above, would be represented as different PractitionerRole instances, each with a different values for PractitionerRole.organization.
Roles which this practitioner may perform
Roles which this practitioner is authorized to perform for the organization.
Need to know what authority the practitioner has - what can they do?
Indicates specific responsibility of an individual within the care team, such as Primary physician, Team coordinator, Caregiver, etc.
.player.HealthCareProvider[@classCode = 'PROV'].code
The location(s) at which this practitioner provides care
The location(s) at which this practitioner provides care.
.performance.ActDefinitionOrEvent.ServiceDeliveryLocation[@classCode = 'SDLOC']
(ServD maps Practitioners and Organizations via another entity, so this concept is not available) However these are accessed via the Site.ServiceSite.ServiceSiteProvider record. (The Site has the location)
The list of healthcare services that this worker provides for this role's Organization/Location(s)
The list of healthcare services that this worker provides for this role's Organization/Location(s).
.player.QualifiedEntity[@classCode = 'QUAL'].code
Contact details that are specific to the role/location/service
Contact details that are specific to the role/location/service.
Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these.
An extension representing the days and times a contact point is available
A reference to an alternative point of contact (NdhPractitionerRole, NdhOrganization, NdhOrganizationAffiliation, or NdhLocation) for this organization
phone | fax | email | pager | url | sms | other
Telecommunications form for contact point - what communications system is required to make use of the contact.
Telecommunications form for contact point.
The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Need to support legacy numbers that are not in a tightly controlled format.
home | work | temp | old | mobile - purpose of this contact point
Identifies the purpose for the contact point.
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Specify preferred order of use (1 = highest)
Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Time period when the contact point was/is in use
Time period when the contact point was/is in use.
A collection of times the practitioner is available or performing this role at the location and/or healthcareservice.
More detailed availability information may be provided in associated Schedule/Slot resources.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Indicates which days of the week are available between the start and end Times.
Is this always available? (hence times are irrelevant) e.g. 24 hour service.
Opening time of day (ignored if allDay = true)
The opening time of day. Note: If the AllDay flag is set, then this time is ignored.
The timezone is expected to be for where this HealthcareService is provided at.
Closing time of day (ignored if allDay = true)
The closing time of day. Note: If the AllDay flag is set, then this time is ignored.
Not available during this time due to provided reason
The practitioner is not available or performing this role during this period of time due to the provided reason.
Reason presented to the user explaining why time not available
The reason that can be presented to the user as to why this time is not available.
Service is not available (seasonally or for a public holiday) from this date.
A description of site availability exceptions, e.g. public holiday availability. Succinctly describing all possible exceptions to normal site availability as details in the available Times and not available Times.
Technical endpoints providing access to services operated for the practitioner with this role
Technical endpoints providing access to services operated for the practitioner with this role.
Organizations have multiple systems that provide various services and ,ay also be different for practitioners too. So the endpoint satisfies the need to be able to define the technical connection details for how to connect to them, and for what purpose.