Background & Scope

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

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

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

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
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:restrictFhirPath		0..*	Expression	NDH usage restriction fhir path URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-restrictFhirPath
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	Indicates the current state of this restriction Binding: ConsentState (required): Indicates the state of the consent.
scope	?!SΣ	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: NDH Consent Scope Value Set (extensible)
category	SΣ	1..*	CodeableConcept	describes the type of restriction (e.g. the data may be further disclosed by the downstream workflow environment per the terms of a Data Use Agreement) Binding: NDH Consent Category Value Set (extensible)
dateTime	SΣ	0..1	dateTime	indicates when the restriction was last updated
policy	S	0..*	BackboneElement	Policies covered by this consent
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
uri	SC	0..1	uri	Specific policy covered by this restriction
policyRule	SΣC	0..1	CodeableConcept	Regulation that this consents to Binding: Consent Policy Rules Value Set (extensible)
provision	SΣ	0..1	BackboneElement	defines access rights for restricted content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..1	code	deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	S	1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference	S	1..1	Reference(NDH CareTeam Profile | NDH Organization Profile | NDH Practitioner Profile | NDH PractitionerRole)	definedUserOrGroup
action	SΣ	0..1	CodeableConcept	reasonType Binding: ConsentActionCodes (extensible)
securityLabel	SΣ	0..*	Coding	userType Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	SΣ	0..*	Coding	reasonName Binding: PurposeOfUse (3.1.0) (extensible)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 From the FHIR Standard
Consent.scope	extensible	ConsentScopeNdhVS(a valid code from NDH ConsentScopeCodes Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentScopeNdhVS From this IG
Consent.category	extensible	ConsentCategoryNdhVS(a valid code from National Healthcare Directory Consent Category Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentCategoryNdhVS From this IG
Consent.policyRule	extensible	ConsentPolicyRulesVS(a valid code from National Healthcare Directory ConsentPolicyRules Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentPolicyRulesVS From this IG
Consent.provision.type	required	ConsentProvisionType http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1 From the FHIR Standard
Consent.provision.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type From the FHIR Standard
Consent.provision.action	extensible	ConsentActionCodes http://hl7.org/fhir/ValueSet/consent-action From the FHIR Standard
Consent.provision.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
Consent.provision.purpose	extensible	PurposeOfUse http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0
Consent.provision.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	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	Consent	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	Consent	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Consent	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()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()
ppc-2	error	Consent	IF Scope=privacy, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()
ppc-3	error	Consent	IF Scope=research, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='research').exists().not()
ppc-4	error	Consent	IF Scope=adr, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()
ppc-5	error	Consent	IF Scope=treatment, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()

This structure is derived from Consent

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent			Consent
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:restrictFhirPath		0..*	Expression	NDH usage restriction fhir path URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-restrictFhirPath
identifier		0..0
status	S	1..1	code	Indicates the current state of this restriction
scope	S	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: NDH Consent Scope Value Set (extensible)
category	S	1..*	CodeableConcept	describes the type of restriction (e.g. the data may be further disclosed by the downstream workflow environment per the terms of a Data Use Agreement) Binding: NDH Consent Category Value Set (extensible)
patient		0..0
dateTime	S	0..1	dateTime	indicates when the restriction was last updated
performer		0..0
organization		0..0
source[x]		0..0
policy	S	0..*	BackboneElement	Policies covered by this consent
authority		0..0
uri	S	0..1	uri	Specific policy covered by this restriction
policyRule	S	0..1	CodeableConcept	Regulation that this consents to Binding: Consent Policy Rules Value Set (extensible)
verification		0..0
provision	S	0..1	BackboneElement	defines access rights for restricted content
type	S	0..1	code	deny | permit
period		0..0
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
role	S	1..1	CodeableConcept	How the actor is involved
reference	S	1..1	Reference(NDH CareTeam Profile | NDH Organization Profile | NDH Practitioner Profile | NDH PractitionerRole)	definedUserOrGroup
action	S	0..1	CodeableConcept	reasonType Binding: ConsentActionCodes (extensible)
securityLabel	S	0..*	Coding	userType
purpose	S	0..*	Coding	reasonName Binding: PurposeOfUse (3.1.0) (extensible)
class		0..0
code		0..0
dataPeriod		0..0
data	S	0..0
provision		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Consent.scope	extensible	ConsentScopeNdhVS(a valid code from NDH ConsentScopeCodes Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentScopeNdhVS From this IG
Consent.category	extensible	ConsentCategoryNdhVS(a valid code from National Healthcare Directory Consent Category Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentCategoryNdhVS From this IG
Consent.policyRule	extensible	ConsentPolicyRulesVS(a valid code from National Healthcare Directory ConsentPolicyRules Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentPolicyRulesVS From this IG
Consent.provision.action	extensible	ConsentActionCodes http://hl7.org/fhir/ValueSet/consent-action From the FHIR Standard
Consent.provision.purpose	extensible	PurposeOfUse http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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:restrictFhirPath		0..*	Expression	NDH usage restriction fhir path URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-restrictFhirPath
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	Indicates the current state of this restriction Binding: ConsentState (required): Indicates the state of the consent.
scope	?!SΣ	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: NDH Consent Scope Value Set (extensible)
category	SΣ	1..*	CodeableConcept	describes the type of restriction (e.g. the data may be further disclosed by the downstream workflow environment per the terms of a Data Use Agreement) Binding: NDH Consent Category Value Set (extensible)
dateTime	SΣ	0..1	dateTime	indicates when the restriction was last updated
policy	S	0..*	BackboneElement	Policies covered by this consent
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
uri	SC	0..1	uri	Specific policy covered by this restriction
policyRule	SΣC	0..1	CodeableConcept	Regulation that this consents to Binding: Consent Policy Rules Value Set (extensible)
provision	SΣ	0..1	BackboneElement	defines access rights for restricted content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..1	code	deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	S	1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference	S	1..1	Reference(NDH CareTeam Profile | NDH Organization Profile | NDH Practitioner Profile | NDH PractitionerRole)	definedUserOrGroup
action	SΣ	0..1	CodeableConcept	reasonType Binding: ConsentActionCodes (extensible)
securityLabel	SΣ	0..*	Coding	userType Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	SΣ	0..*	Coding	reasonName Binding: PurposeOfUse (3.1.0) (extensible)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 From the FHIR Standard
Consent.scope	extensible	ConsentScopeNdhVS(a valid code from NDH ConsentScopeCodes Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentScopeNdhVS From this IG
Consent.category	extensible	ConsentCategoryNdhVS(a valid code from National Healthcare Directory Consent Category Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentCategoryNdhVS From this IG
Consent.policyRule	extensible	ConsentPolicyRulesVS(a valid code from National Healthcare Directory ConsentPolicyRules Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentPolicyRulesVS From this IG
Consent.provision.type	required	ConsentProvisionType http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1 From the FHIR Standard
Consent.provision.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type From the FHIR Standard
Consent.provision.action	extensible	ConsentActionCodes http://hl7.org/fhir/ValueSet/consent-action From the FHIR Standard
Consent.provision.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
Consent.provision.purpose	extensible	PurposeOfUse http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0
Consent.provision.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	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	Consent	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	Consent	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Consent	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()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()
ppc-2	error	Consent	IF Scope=privacy, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()
ppc-3	error	Consent	IF Scope=research, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='research').exists().not()
ppc-4	error	Consent	IF Scope=adr, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()
ppc-5	error	Consent	IF Scope=treatment, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
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:restrictFhirPath		0..*	Expression	NDH usage restriction fhir path URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-restrictFhirPath
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	Indicates the current state of this restriction Binding: ConsentState (required): Indicates the state of the consent.
scope	?!SΣ	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: NDH Consent Scope Value Set (extensible)
category	SΣ	1..*	CodeableConcept	describes the type of restriction (e.g. the data may be further disclosed by the downstream workflow environment per the terms of a Data Use Agreement) Binding: NDH Consent Category Value Set (extensible)
dateTime	SΣ	0..1	dateTime	indicates when the restriction was last updated
policy	S	0..*	BackboneElement	Policies covered by this consent
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
uri	SC	0..1	uri	Specific policy covered by this restriction
policyRule	SΣC	0..1	CodeableConcept	Regulation that this consents to Binding: Consent Policy Rules Value Set (extensible)
provision	SΣ	0..1	BackboneElement	defines access rights for restricted content
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..1	code	deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	S	1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference	S	1..1	Reference(NDH CareTeam Profile | NDH Organization Profile | NDH Practitioner Profile | NDH PractitionerRole)	definedUserOrGroup
action	SΣ	0..1	CodeableConcept	reasonType Binding: ConsentActionCodes (extensible)
securityLabel	SΣ	0..*	Coding	userType Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	SΣ	0..*	Coding	reasonName Binding: PurposeOfUse (3.1.0) (extensible)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 From the FHIR Standard
Consent.scope	extensible	ConsentScopeNdhVS(a valid code from NDH ConsentScopeCodes Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentScopeNdhVS From this IG
Consent.category	extensible	ConsentCategoryNdhVS(a valid code from National Healthcare Directory Consent Category Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentCategoryNdhVS From this IG
Consent.policyRule	extensible	ConsentPolicyRulesVS(a valid code from National Healthcare Directory ConsentPolicyRules Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentPolicyRulesVS From this IG
Consent.provision.type	required	ConsentProvisionType http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1 From the FHIR Standard
Consent.provision.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type From the FHIR Standard
Consent.provision.action	extensible	ConsentActionCodes http://hl7.org/fhir/ValueSet/consent-action From the FHIR Standard
Consent.provision.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
Consent.provision.purpose	extensible	PurposeOfUse http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0
Consent.provision.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	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	Consent	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	Consent	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Consent	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()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()
ppc-2	error	Consent	IF Scope=privacy, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()
ppc-3	error	Consent	IF Scope=research, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='research').exists().not()
ppc-4	error	Consent	IF Scope=adr, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()
ppc-5	error	Consent	IF Scope=treatment, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()

Differential View

This structure is derived from Consent

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent			Consent
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:restrictFhirPath		0..*	Expression	NDH usage restriction fhir path URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-restrictFhirPath
identifier		0..0
status	S	1..1	code	Indicates the current state of this restriction
scope	S	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: NDH Consent Scope Value Set (extensible)
category	S	1..*	CodeableConcept	describes the type of restriction (e.g. the data may be further disclosed by the downstream workflow environment per the terms of a Data Use Agreement) Binding: NDH Consent Category Value Set (extensible)
patient		0..0
dateTime	S	0..1	dateTime	indicates when the restriction was last updated
performer		0..0
organization		0..0
source[x]		0..0
policy	S	0..*	BackboneElement	Policies covered by this consent
authority		0..0
uri	S	0..1	uri	Specific policy covered by this restriction
policyRule	S	0..1	CodeableConcept	Regulation that this consents to Binding: Consent Policy Rules Value Set (extensible)
verification		0..0
provision	S	0..1	BackboneElement	defines access rights for restricted content
type	S	0..1	code	deny | permit
period		0..0
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
role	S	1..1	CodeableConcept	How the actor is involved
reference	S	1..1	Reference(NDH CareTeam Profile | NDH Organization Profile | NDH Practitioner Profile | NDH PractitionerRole)	definedUserOrGroup
action	S	0..1	CodeableConcept	reasonType Binding: ConsentActionCodes (extensible)
securityLabel	S	0..*	Coding	userType
purpose	S	0..*	Coding	reasonName Binding: PurposeOfUse (3.1.0) (extensible)
class		0..0
code		0..0
dataPeriod		0..0
data	S	0..0
provision		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Consent.scope	extensible	ConsentScopeNdhVS(a valid code from NDH ConsentScopeCodes Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentScopeNdhVS From this IG
Consent.category	extensible	ConsentCategoryNdhVS(a valid code from National Healthcare Directory Consent Category Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentCategoryNdhVS From this IG
Consent.policyRule	extensible	ConsentPolicyRulesVS(a valid code from National Healthcare Directory ConsentPolicyRules Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentPolicyRulesVS From this IG
Consent.provision.action	extensible	ConsentActionCodes http://hl7.org/fhir/ValueSet/consent-action From the FHIR Standard
Consent.provision.purpose	extensible	PurposeOfUse http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Consent	C	0..*	Consent	A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time Constraints: ppc-1, ppc-2, ppc-3, ppc-4, ppc-5
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
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:restrictFhirPath		0..*	Expression	NDH usage restriction fhir path URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-restrictFhirPath
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	Indicates the current state of this restriction Binding: ConsentState (required): Indicates the state of the consent.
scope	?!SΣ	1..1	CodeableConcept	Which of the four areas this resource covers (extensible) Binding: NDH Consent Scope Value Set (extensible)
category	SΣ	1..*	CodeableConcept	describes the type of restriction (e.g. the data may be further disclosed by the downstream workflow environment per the terms of a Data Use Agreement) Binding: NDH Consent Category Value Set (extensible)
dateTime	SΣ	0..1	dateTime	indicates when the restriction was last updated
policy	S	0..*	BackboneElement	Policies covered by this consent
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
uri	SC	0..1	uri	Specific policy covered by this restriction
policyRule	SΣC	0..1	CodeableConcept	Regulation that this consents to Binding: Consent Policy Rules Value Set (extensible)
provision	SΣ	0..1	BackboneElement	defines access rights for restricted content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..1	code	deny | permit Binding: ConsentProvisionType (required): How a rule statement is applied, such as adding additional consent or removing consent.
actor	S	1..*	BackboneElement	Who|what controlled by this rule (or group, by role)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
role	S	1..1	CodeableConcept	How the actor is involved Binding: SecurityRoleType (extensible): How an actor is involved in the consent considerations.
reference	S	1..1	Reference(NDH CareTeam Profile | NDH Organization Profile | NDH Practitioner Profile | NDH PractitionerRole)	definedUserOrGroup
action	SΣ	0..1	CodeableConcept	reasonType Binding: ConsentActionCodes (extensible)
securityLabel	SΣ	0..*	Coding	userType Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
purpose	SΣ	0..*	Coding	reasonName Binding: PurposeOfUse (3.1.0) (extensible)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Consent.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Consent.status	required	ConsentState http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1 From the FHIR Standard
Consent.scope	extensible	ConsentScopeNdhVS(a valid code from NDH ConsentScopeCodes Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentScopeNdhVS From this IG
Consent.category	extensible	ConsentCategoryNdhVS(a valid code from National Healthcare Directory Consent Category Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentCategoryNdhVS From this IG
Consent.policyRule	extensible	ConsentPolicyRulesVS(a valid code from National Healthcare Directory ConsentPolicyRules Code System) http://hl7.org/fhir/us/ndh/ValueSet/ConsentPolicyRulesVS From this IG
Consent.provision.type	required	ConsentProvisionType http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1 From the FHIR Standard
Consent.provision.actor.role	extensible	SecurityRoleType http://hl7.org/fhir/ValueSet/security-role-type From the FHIR Standard
Consent.provision.action	extensible	ConsentActionCodes http://hl7.org/fhir/ValueSet/consent-action From the FHIR Standard
Consent.provision.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
Consent.provision.purpose	extensible	PurposeOfUse http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0
Consent.provision.data.meaning	required	ConsentDataMeaning http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Consent	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Consent	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	Consent	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	Consent	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Consent	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()
ppc-1	error	Consent	Either a Policy or PolicyRule : policy.exists() or policyRule.exists()
ppc-2	error	Consent	IF Scope=privacy, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not()
ppc-3	error	Consent	IF Scope=research, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='research').exists().not()
ppc-4	error	Consent	IF Scope=adr, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='adr').exists().not()
ppc-5	error	Consent	IF Scope=treatment, there must be a patient : patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not()

This structure is derived from Consent

Summary

Mandatory: 0 element(1 nested mandatory element)
Must-Support: 21 elements
Prohibited: 13 elements

Structures

This structure refers to these other structures:

• NDH CareTeam Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-CareTeam)
• NDH Organization Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Organization)
• NDH Practitioner Profile (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Practitioner)
• NDH PractitionerRole (http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-PractitionerRole)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-restrictFhirPath

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
• Concent Search Parameter from Registry