Generated Narrative: StructureDefinition ndh-Group Name Flags Card. Type Description & Constraints Group 0..* Group Group of multiple entities #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:location 0..* Reference(NDH Location Profile) Network coverage area URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-location-reference #xD; extension:endpoint 0..* Reference(NDH Endpoint Profile) Endpoint Reference URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-endpoint-reference #xD; extension:verification-status 0..1 CodeableConcept Group Verification Status URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-verification-status Binding: NDH Verification Status Value Set (extensible) #xD; extension:artifact-description 0..1 markdown Group Description URL: http://hl7.org/fhir/StructureDefinition/artifact-description #xD; extension:artifact-effectivePeriod 0..1 Period Group Effective Period URL: http://hl7.org/fhir/StructureDefinition/artifact-effectivePeriod #xD; identifier S 0..* Identifier Unique id #xD; active S 1..1 boolean Whether this group's record is in active use Fixed Value: true #xD; type 1..1 code person | animal | practitioner | device | medication | substance Fixed Value: practitioner #xD; actual 1..1 boolean Descriptive or actual Fixed Value: true #xD; code S 1..1 CodeableConcept Kind of Group members Binding: Healthcare Service Category Value Set (extensible) #xD; name S 1..1 string Label for Group #xD; managingEntity S 0..1 Reference(NDH Organization Profile) Entity that is the custodian of the Group's definition #xD; member S 0..* BackboneElement Who or what is in group #xD; entity 1..1 Reference(NDH Practitioner Profile | NDH PractitionerRole) Reference to the group member #xD; period S 0..1 Period Period member belonged to the group #xD; inactive S 0..1 boolean If member is no longer in group #xD; Documentation for this format
HL7 International / Patient Administration
The NDH Group represents a group of multi-disciplinary providers organized around a specific healthcare program or service, not an individual patient. For example, a diabetic care team may include an endocrinologist, a diabetes educator, and a nutritionist.
Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.
If both Group.characteristic and Group.member are present, then the members are the individuals who were found who met the characteristic. It's possible that there might be other candidate members who meet the characteristic and aren't (yet) in the list. All members SHALL have the listed characteristics.
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
Can only have members if group is "actual"
f:actual/@value=true() or not(exists(f:member))
Entity[determinerCode="GRP" or determinerCode="GRP_KIND"]
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.
A reference to a Location resource (NDH-Location) defining the coverage area of a health insurance provider network
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
The technical details of an endpoint that can be used for electronic services
Indicates a resource instance verification status
A free text natural language description of the artifact from a consumer's perspective.
This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the artifact as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the artifact is presumed to be the predominant language in the place the artifact was created).
The period during which the artifact content was or is planned to be in active use.
The effective period for an artifact determines when the content is applicable for usage and is independent of publication and review dates. For example, an artifact intended to be used for the year 2016 might be published in 2015.
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
A unique business identifier for this group.
Allows the group to be referenced from external specifications.
unique(./id[displayable="true" and scope="OBJ"])
Whether this group's record is in active use
Indicates whether the record for the group is available for use or is merely being retained for historical purposes.
Need to be able to mark a group record as not to be used because it was created in error or is otherwise no longer available (e.g. a herd that no longer exists).
This resource is generally assumed to be active if no value is provided for the active element
person | animal | practitioner | device | medication | substance
Identifies the broad classification of the kind of resources the group includes.
Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).
Identifies what type of resources the group is made up of.
Types of resources that are part of group.
person: ./classCode="PSN" animal: ./classCode="ANM" device: ./classCode="DEV" medication: ./classCode="MMAT" and ./playedRole[isNormalRole() and classCode="THER"] food: ./classCode="FOOD"
If true, indicates that the resource refers to a specific group of real individuals. If false, the group defines a set of intended individuals.
There are use-cases for groups that define specific collections of individuals, and other groups that define "types" of intended individuals. The requirements for both kinds of groups are similar, so we use a single resource, distinguished by this flag.
true: ./determinerCode="GRP" false: ./determinerCode="GRP_KIND"
Provides a specific type of resource the group includes; e.g. "cow", "syringe", etc.
This would generally be omitted for Person resources.
A label assigned to the group for human identification and communication.
Used to identify the group in human communication.
A count of the number of resource instances that are part of the group.
Note that the quantity may be less than the number of members if some of the members are not active.
Group size is a common defining characteristic.
Entity that is the custodian of the Group's definition
Entity responsible for defining and maintaining Group characteristics and/or registered members.
This does not strictly align with ownership of a herd or flock, but may suffice to represent that relationship in simple cases. More complex cases will require an extension.
Include / Exclude group members by Trait
Identifies traits whose presence r absence is shared by members of the group.
All the identified characteristics must be true for an entity to a member of the group.
Needs to be a generic mechanism for identifying what individuals can be part of a group.
./playedRole[isNormalRole()]/participation[isNormalParticipation() and typeCode="SBJ"]/act[isNormalAct and classCode="OBS" and moodCode="EVN"]
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
A code that identifies the kind of trait being asserted.
Need a formal way of identifying the characteristic being described.
List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.
The value of the trait that holds (or does not hold - see 'exclude') for members of the group.
For Range, it means members of the group have a value that falls somewhere within the specified range.
The value of the characteristic is what determines group membership.
Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.
If true, indicates the characteristic is one that is NOT held by members of the group.
This is labeled as "Is Modifier" because applications cannot wrongly include excluded members as included or vice versa.
Sometimes group membership is determined by characteristics not possessed.
Period over which characteristic is tested
The period over which the characteristic is tested; e.g. the patient had an operation during the month of June.
Identifies the resource instances that are members of the group.
Often the only thing of interest about a group is "who's in it".
./scopedRole[isNormalRole() and classCode="MBR"]/player
A reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the same.
The period that the member was in the group, if known.
Need to track who was in a group at a particular time.
A flag to indicate that the member is no longer in the group, but previously may have been a member.
Sometimes you don't know when someone stopped being in a group, but not when.
Members are considered active unless explicitly specified otherwise