National Directory of Healthcare Providers & Services (NDH) Implementation Guide
2.0.0-current - ci-build

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 2.0.0-current 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 OrganizationAffiliation Profile

Official URL: http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-OrganizationAffiliation | Version: 2.0.0-current
Standards status: Trial-use | Maturity Level: 4 | Computable Name: NdhOrganizationAffiliation

The OrganizationAffiliation resource describes relationships between two or more organizations, including the services one organization provides another, the location(s) where they provide services, the availability of those services, electronic endpoints, and other relevant information.

### 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.

Usages:

- Refer to this Profile: NDH Via Intermediary
- Examples for this Profile: OrganizationAffiliation/BurrClinicAffil, OrganizationAffiliation/OrgOneNetwork1Affiliation, OrganizationAffiliation/OrgOneNetwork2Affiliation and OrganizationAffiliation/PharmChainAffil1
- CapabilityStatements using this Profile: NDH Server Capability Statement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OrganizationAffiliation | C | 0..* | OrganizationAffiliation | Defines an affiliation/assotiation/relationship between 2 distinct oganizations, that is not a part-of relationship/sub-division relationship Constraints: organization-or-participatingOrganization
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:qualification |  | 0..* | (Complex) | Qualification URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
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)
extension:logo |  | 0..1 | Attachment | NDH Logo URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-logo
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Business identifiers that are specific to this role
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)
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
assigner | Σ | 0..1 | Reference(NDH Organization Profile) | Organization that issued id (may be just text)
active | Σ | 1..1 | boolean | Whether this organization affiliation record is in active use Required Pattern: true
period | S Σ | 0..1 | Period | The period during which the participatingOrganization is affiliated with the primary organization
organization | S Σ | 0..1 | Reference(NDH Organization Profile) | Organization where the role is available
participatingOrganization | S Σ | 0..1 | Reference(NDH Organization Profile) | Organization that provides/performs the role (e.g. providing services or is a member of)
network | Σ | 0..* | Reference(NDH Network Profile) | Health insurance provider network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
code | Σ | 0..* | CodeableConcept | Definition of the role the participatingOrganization plays Binding: OrganizationAffiliation Roles (extensible)
specialty | Σ | 0..* | CodeableConcept | Specific specialty of the participatingOrganization in the context of the role Binding: PracticeSettingCodeValueSet (preferred): Specific specialty associated with the participating organization.
Additional Bindings | Purpose | Documentation
HealthcareProviderTaxonomy (20240606) | Extensible | The specialty(ies) at the organization in this affiliation.
location | S Σ | 0..* | Reference(NDH Location Profile) | The location(s) at which the role occurs
healthcareService |  | 0..* | Reference(NDH HealthcareService Profile) | Healthcare services provided through the role
telecom | Σ | 0..* | ContactPoint | Contact details at the participatingOrganization relevant to this Affiliation
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
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
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
endpoint | S | 0..* | Reference(NDH Endpoint Profile) | Technical endpoints providing access to services operated for this role
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
OrganizationAffiliation.​identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​code | Base | extensible | OrganizationAffiliation Roles | 📦2.0.0-current | This IG
OrganizationAffiliation.​specialty | Base | preferred | Practice Setting Code Value Set | 📦4.0.1 | FHIR Std.
OrganizationAffiliation.​telecom.use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | OrganizationAffiliation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | OrganizationAffiliation | 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()`
dom-4 | error | OrganizationAffiliation | 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()`
dom-5 | error | OrganizationAffiliation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | OrganizationAffiliation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
organization-or-participatingOrganization | error | OrganizationAffiliation | NdhOrganizationAffiliation.organization or NdhOrganizationAffiliation.participatingOrganization | `organization.exists() or participatingOrganization.exists()`

This structure is derived from OrganizationAffiliation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OrganizationAffiliation | C | 0..* | OrganizationAffiliation | Defines an affiliation/assotiation/relationship between 2 distinct oganizations, that is not a part-of relationship/sub-division relationship Constraints: organization-or-participatingOrganization
meta |  |  |  |
lastUpdated |  | 1..1 | instant | When the resource version last changed
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:qualification |  | 0..* | (Complex) | Qualification URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
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)
extension:logo |  | 0..1 | Attachment | NDH Logo URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-logo
identifier | S | 0..* | Identifier | Business identifiers that are specific to this role
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)
assigner |  | 0..1 | Reference(NDH Organization Profile) | Organization that issued id (may be just text)
active |  | 1..1 | boolean | Whether this organization affiliation record is in active use Required Pattern: true
period | S | 0..1 | Period | The period during which the participatingOrganization is affiliated with the primary organization
organization | S | 0..1 | Reference(NDH Organization Profile) | Organization where the role is available
participatingOrganization | S | 0..1 | Reference(NDH Organization Profile) | Organization that provides/performs the role (e.g. providing services or is a member of)
network |  | 0..* | Reference(NDH Network Profile) | Health insurance provider network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
code |  | 0..* | CodeableConcept | Definition of the role the participatingOrganization plays Binding: OrganizationAffiliation Roles (extensible)
specialty |  | 0..* | CodeableConcept | Specific specialty of the participatingOrganization in the context of the role Binding: PracticeSettingCodeValueSet (preferred): Specific specialty associated with the participating organization.
Additional Bindings | Purpose | Documentation
HealthcareProviderTaxonomy (20240606) | Extensible | The specialty(ies) at the organization in this affiliation.
location | S | 0..* | Reference(NDH Location Profile) | The location(s) at which the role occurs
healthcareService |  | 0..* | Reference(NDH HealthcareService Profile) | Healthcare services provided through the role
telecom |  | 0..* | ContactPoint | Contact details at the participatingOrganization relevant to this Affiliation
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
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
endpoint | S | 0..* | Reference(NDH Endpoint Profile) | Technical endpoints providing access to services operated for this role
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
OrganizationAffiliation.​code | Base | extensible | OrganizationAffiliation Roles | 📦2.0.0-current | This IG
OrganizationAffiliation.​specialty | Base | preferred | Practice Setting Code Value Set | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
organization-or-participatingOrganization | error | OrganizationAffiliation | NdhOrganizationAffiliation.organization or NdhOrganizationAffiliation.participatingOrganization | `organization.exists() or participatingOrganization.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OrganizationAffiliation | C | 0..* | OrganizationAffiliation | Defines an affiliation/assotiation/relationship between 2 distinct oganizations, that is not a part-of relationship/sub-division relationship Constraints: organization-or-participatingOrganization
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 1..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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 |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:qualification |  | 0..* | (Complex) | Qualification URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
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)
extension:logo |  | 0..1 | Attachment | NDH Logo URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-logo
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Business identifiers that are specific to this role
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
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)
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 0..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(NDH Organization Profile) | Organization that issued id (may be just text)
active | Σ | 1..1 | boolean | Whether this organization affiliation record is in active use Required Pattern: true
period | S Σ | 0..1 | Period | The period during which the participatingOrganization is affiliated with the primary organization
organization | S Σ | 0..1 | Reference(NDH Organization Profile) | Organization where the role is available
participatingOrganization | S Σ | 0..1 | Reference(NDH Organization Profile) | Organization that provides/performs the role (e.g. providing services or is a member of)
network | Σ | 0..* | Reference(NDH Network Profile) | Health insurance provider network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
code | Σ | 0..* | CodeableConcept | Definition of the role the participatingOrganization plays Binding: OrganizationAffiliation Roles (extensible)
specialty | Σ | 0..* | CodeableConcept | Specific specialty of the participatingOrganization in the context of the role Binding: PracticeSettingCodeValueSet (preferred): Specific specialty associated with the participating organization.
Additional Bindings | Purpose | Documentation
HealthcareProviderTaxonomy (20240606) | Extensible | The specialty(ies) at the organization in this affiliation.
location | S Σ | 0..* | Reference(NDH Location Profile) | The location(s) at which the role occurs
healthcareService |  | 0..* | Reference(NDH HealthcareService Profile) | Healthcare services provided through the role
telecom | Σ | 0..* | ContactPoint | Contact details at the participatingOrganization relevant to this Affiliation
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:contactpoint-availabletime |  | 0..* | (Complex) | NDH Contactpoint Availabletime URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-contactpoint-availabletime
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
system | Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
endpoint | S | 0..* | Reference(NDH Endpoint Profile) | Technical endpoints providing access to services operated for this role
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
OrganizationAffiliation.​meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​identifier.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​code | Base | extensible | OrganizationAffiliation Roles | 📦2.0.0-current | This IG
OrganizationAffiliation.​specialty | Base | preferred | Practice Setting Code Value Set | 📦4.0.1 | FHIR Std.
OrganizationAffiliation.​telecom.system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​telecom.use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | OrganizationAffiliation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | OrganizationAffiliation | 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()`
dom-4 | error | OrganizationAffiliation | 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()`
dom-5 | error | OrganizationAffiliation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | OrganizationAffiliation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
organization-or-participatingOrganization | error | OrganizationAffiliation | NdhOrganizationAffiliation.organization or NdhOrganizationAffiliation.participatingOrganization | `organization.exists() or participatingOrganization.exists()`

This structure is derived from OrganizationAffiliation

Summary

Mandatory: 1 element(1 nested mandatory element)
Must-Support: 6 elements

Structures

This structure refers to these other structures:

- NDH Organization Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Organization)
- NDH Network Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Network)
- NDH Location Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Location)
- NDH HealthcareService Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-HealthcareService)
- NDH Endpoint Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Endpoint)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-verification-status
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-logo
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-identifier-status
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-contactpoint-availabletime
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-via-intermediary

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OrganizationAffiliation | C | 0..* | OrganizationAffiliation | Defines an affiliation/assotiation/relationship between 2 distinct oganizations, that is not a part-of relationship/sub-division relationship Constraints: organization-or-participatingOrganization
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:qualification |  | 0..* | (Complex) | Qualification URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
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)
extension:logo |  | 0..1 | Attachment | NDH Logo URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-logo
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Business identifiers that are specific to this role
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)
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
assigner | Σ | 0..1 | Reference(NDH Organization Profile) | Organization that issued id (may be just text)
active | Σ | 1..1 | boolean | Whether this organization affiliation record is in active use Required Pattern: true
period | S Σ | 0..1 | Period | The period during which the participatingOrganization is affiliated with the primary organization
organization | S Σ | 0..1 | Reference(NDH Organization Profile) | Organization where the role is available
participatingOrganization | S Σ | 0..1 | Reference(NDH Organization Profile) | Organization that provides/performs the role (e.g. providing services or is a member of)
network | Σ | 0..* | Reference(NDH Network Profile) | Health insurance provider network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
code | Σ | 0..* | CodeableConcept | Definition of the role the participatingOrganization plays Binding: OrganizationAffiliation Roles (extensible)
specialty | Σ | 0..* | CodeableConcept | Specific specialty of the participatingOrganization in the context of the role Binding: PracticeSettingCodeValueSet (preferred): Specific specialty associated with the participating organization.
Additional Bindings | Purpose | Documentation
HealthcareProviderTaxonomy (20240606) | Extensible | The specialty(ies) at the organization in this affiliation.
location | S Σ | 0..* | Reference(NDH Location Profile) | The location(s) at which the role occurs
healthcareService |  | 0..* | Reference(NDH HealthcareService Profile) | Healthcare services provided through the role
telecom | Σ | 0..* | ContactPoint | Contact details at the participatingOrganization relevant to this Affiliation
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
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
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
endpoint | S | 0..* | Reference(NDH Endpoint Profile) | Technical endpoints providing access to services operated for this role
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
OrganizationAffiliation.​identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​code | Base | extensible | OrganizationAffiliation Roles | 📦2.0.0-current | This IG
OrganizationAffiliation.​specialty | Base | preferred | Practice Setting Code Value Set | 📦4.0.1 | FHIR Std.
OrganizationAffiliation.​telecom.use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | OrganizationAffiliation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | OrganizationAffiliation | 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()`
dom-4 | error | OrganizationAffiliation | 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()`
dom-5 | error | OrganizationAffiliation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | OrganizationAffiliation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
organization-or-participatingOrganization | error | OrganizationAffiliation | NdhOrganizationAffiliation.organization or NdhOrganizationAffiliation.participatingOrganization | `organization.exists() or participatingOrganization.exists()`

Differential View

This structure is derived from OrganizationAffiliation

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OrganizationAffiliation | C | 0..* | OrganizationAffiliation | Defines an affiliation/assotiation/relationship between 2 distinct oganizations, that is not a part-of relationship/sub-division relationship Constraints: organization-or-participatingOrganization
meta |  |  |  |
lastUpdated |  | 1..1 | instant | When the resource version last changed
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:qualification |  | 0..* | (Complex) | Qualification URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
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)
extension:logo |  | 0..1 | Attachment | NDH Logo URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-logo
identifier | S | 0..* | Identifier | Business identifiers that are specific to this role
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)
assigner |  | 0..1 | Reference(NDH Organization Profile) | Organization that issued id (may be just text)
active |  | 1..1 | boolean | Whether this organization affiliation record is in active use Required Pattern: true
period | S | 0..1 | Period | The period during which the participatingOrganization is affiliated with the primary organization
organization | S | 0..1 | Reference(NDH Organization Profile) | Organization where the role is available
participatingOrganization | S | 0..1 | Reference(NDH Organization Profile) | Organization that provides/performs the role (e.g. providing services or is a member of)
network |  | 0..* | Reference(NDH Network Profile) | Health insurance provider network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
code |  | 0..* | CodeableConcept | Definition of the role the participatingOrganization plays Binding: OrganizationAffiliation Roles (extensible)
specialty |  | 0..* | CodeableConcept | Specific specialty of the participatingOrganization in the context of the role Binding: PracticeSettingCodeValueSet (preferred): Specific specialty associated with the participating organization.
Additional Bindings | Purpose | Documentation
HealthcareProviderTaxonomy (20240606) | Extensible | The specialty(ies) at the organization in this affiliation.
location | S | 0..* | Reference(NDH Location Profile) | The location(s) at which the role occurs
healthcareService |  | 0..* | Reference(NDH HealthcareService Profile) | Healthcare services provided through the role
telecom |  | 0..* | ContactPoint | Contact details at the participatingOrganization relevant to this Affiliation
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
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
endpoint | S | 0..* | Reference(NDH Endpoint Profile) | Technical endpoints providing access to services operated for this role
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
OrganizationAffiliation.​code | Base | extensible | OrganizationAffiliation Roles | 📦2.0.0-current | This IG
OrganizationAffiliation.​specialty | Base | preferred | Practice Setting Code Value Set | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
organization-or-participatingOrganization | error | OrganizationAffiliation | NdhOrganizationAffiliation.organization or NdhOrganizationAffiliation.participatingOrganization | `organization.exists() or participatingOrganization.exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OrganizationAffiliation | C | 0..* | OrganizationAffiliation | Defines an affiliation/assotiation/relationship between 2 distinct oganizations, that is not a part-of relationship/sub-division relationship Constraints: organization-or-participatingOrganization
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
versionId | Σ | 0..1 | id | Version specific identifier
lastUpdated | Σ | 1..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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 |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:qualification |  | 0..* | (Complex) | Qualification URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
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)
extension:logo |  | 0..1 | Attachment | NDH Logo URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-logo
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Business identifiers that are specific to this role
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
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)
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 0..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(NDH Organization Profile) | Organization that issued id (may be just text)
active | Σ | 1..1 | boolean | Whether this organization affiliation record is in active use Required Pattern: true
period | S Σ | 0..1 | Period | The period during which the participatingOrganization is affiliated with the primary organization
organization | S Σ | 0..1 | Reference(NDH Organization Profile) | Organization where the role is available
participatingOrganization | S Σ | 0..1 | Reference(NDH Organization Profile) | Organization that provides/performs the role (e.g. providing services or is a member of)
network | Σ | 0..* | Reference(NDH Network Profile) | Health insurance provider network in which the participatingOrganization provides the role's services (if defined) at the indicated locations (if defined)
code | Σ | 0..* | CodeableConcept | Definition of the role the participatingOrganization plays Binding: OrganizationAffiliation Roles (extensible)
specialty | Σ | 0..* | CodeableConcept | Specific specialty of the participatingOrganization in the context of the role Binding: PracticeSettingCodeValueSet (preferred): Specific specialty associated with the participating organization.
Additional Bindings | Purpose | Documentation
HealthcareProviderTaxonomy (20240606) | Extensible | The specialty(ies) at the organization in this affiliation.
location | S Σ | 0..* | Reference(NDH Location Profile) | The location(s) at which the role occurs
healthcareService |  | 0..* | Reference(NDH HealthcareService Profile) | Healthcare services provided through the role
telecom | Σ | 0..* | ContactPoint | Contact details at the participatingOrganization relevant to this Affiliation
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:contactpoint-availabletime |  | 0..* | (Complex) | NDH Contactpoint Availabletime URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-contactpoint-availabletime
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
system | Σ C | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value | Σ | 0..1 | string | The actual contact point details
use | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest)
period | Σ | 0..1 | Period | Time period when the contact point was/is in use
endpoint | S | 0..* | Reference(NDH Endpoint Profile) | Technical endpoints providing access to services operated for this role
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
OrganizationAffiliation.​meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​identifier.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​identifier.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​code | Base | extensible | OrganizationAffiliation Roles | 📦2.0.0-current | This IG
OrganizationAffiliation.​specialty | Base | preferred | Practice Setting Code Value Set | 📦4.0.1 | FHIR Std.
OrganizationAffiliation.​telecom.system | Base | required | ContactPointSystem | 📍4.0.1 | FHIR Std.
OrganizationAffiliation.​telecom.use | Base | required | ContactPointUse | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | OrganizationAffiliation | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | OrganizationAffiliation | 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()`
dom-4 | error | OrganizationAffiliation | 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()`
dom-5 | error | OrganizationAffiliation | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | OrganizationAffiliation | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
organization-or-participatingOrganization | error | OrganizationAffiliation | NdhOrganizationAffiliation.organization or NdhOrganizationAffiliation.participatingOrganization | `organization.exists() or participatingOrganization.exists()`

This structure is derived from OrganizationAffiliation

Summary

Mandatory: 1 element(1 nested mandatory element)
Must-Support: 6 elements

Structures

This structure refers to these other structures:

- NDH Organization Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Organization)
- NDH Network Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Network)
- NDH Location Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Location)
- NDH HealthcareService Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-HealthcareService)
- NDH Endpoint Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Endpoint)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-qualification
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-verification-status
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-logo
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-identifier-status
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-contactpoint-availabletime
- http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-via-intermediary

Maturity: 4

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]/OrganizationAffiliation?location.address-state=CT`
participating-organization | reference | `GET [base]/OrganizationAffiliation?participating-organization.address-state=FL`
primary-organization | reference | `GET [base]/OrganizationAffiliation?primary-organization.address-state=FL`
verification-status | token | `GET [base]/OrganizationAffiliation?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.

- Search Parameter Registry
- OrganizationAffiliation Search Parameter from Registry

SearchParameter Name | Type | Example
--- | --- | ---
endpoint | reference | `GET [base]/OrganizationAffiliation?endpoint.connection-type=hl7-fhir-rest`
identifier | token | `GET [base]/OrganizationAffiliation?identifier=123456`
network | reference | `GET [base]/OrganizationAffiliation?network.type=ntwk&network.address-state=FL`
role | token | `GET [base]/OrganizationAffiliation?role=group`
service | reference | `GET [base]/OrganizationAffiliation?service.address-state=FL`
specialty | token | `GET [base]/OrganizationAffiliation?specialty=103T00000X`

#### _include Search Parameter

_include | Example
--- | ---
OrganizationAffiliation:network | `GET [base]/OrganizationAffiliation?_include=OrganizationAffiliation:network`
OrganizationAffiliation:participating-organization | `GET [base]/OrganizationAffiliation?_include=OrganizationAffiliation:participating-organization`
OrganizationAffiliation:primary-organization | `GET [base]/OrganizationAffiliation?_include=OrganizationAffiliation:primary-organization`

#### _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