US Quality Core Implementation Guide
1.0.0-ballot - STU 1 - ballot United States of America flag

US Quality Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-quality-core/ and changes regularly. See the Directory of published versions

Resource Profile: US Quality Core CommunicationDone

Official URL: http://hl7.org/fhir/us/quality-core/StructureDefinition/us-quality-core-communicationdone Version: 1.0.0-ballot
Standards status: Trial-use Maturity Level: 4 Computable Name: USQualityCoreCommunicationDone
Other Identifiers: OID:2.16.840.1.113883.4.642.40.78.42.6

Positive profile of Communication for decision support/quality metrics. Indicates that the communication was performed (as opposed to the not done profile).

The Communication profile defines the conformance expectations for a Communication event, regardless of whether it is a positive or negative statement.

The CommunicationDone and CommunicationNotDone profiles represent the positive and negative statements for a communication event.

To create an expression indicating existence of a communication, use the profile USQualityCoreCommunicationDone; to specifically request information that a communication intentionally did not occur for a medical, patient or system reason, use the profile USQualityCoreCommunicationNotDone.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V2 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V2 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are flagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

Profile element Description USCDI+ Quality Data Element(s)
category Message category Communications: Communication Topic
sent When sent Communications: Communication Status
status preparation | in-progress | on-hold | stopped | completed Communications: Communication Status
subject Focus of message Communications: Communication Topic
topic Description of the purpose/content Communications: Communication Topic
topic.extension:codeOptions Url of a value set of candidate topics Communications: Communication Topic

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication C 0..* USQualityCoreCommunication A record of information transmitted from a sender to a receiver
Constraints: com-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code (USCDI+ Quality) preparation | in-progress | on-hold | stopped | completed
Binding: Positive Event Status (required)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Communication.status Base required Positive Event Status 📦1.0.0-ballot This IG

Constraints

Id Grade Path(s) Description Expression
com-1 error Communication to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())
dom-2 error Communication If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Communication 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 Communication 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 Communication If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Communication 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()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication 0..* USQualityCoreCommunication A record of information transmitted from a sender to a receiver
... status 1..1 code (USCDI+ Quality) preparation | in-progress | on-hold | stopped | completed
Binding: Positive Event Status (required)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Communication.status Base required Positive Event Status 📦1.0.0-ballot This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication C 0..* USQualityCoreCommunication A record of information transmitted from a sender to a receiver
Constraints: com-1
... 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 BindingsPurpose
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
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Unique identifier
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(Resource) Request fulfilled by this communication
... partOf Σ 0..* Reference(Resource) Part of this action
... inResponseTo 0..* Reference(Communication) Reply to
... status ?!Σ 1..1 code (USCDI+ Quality) preparation | in-progress | on-hold | stopped | completed
Binding: Positive Event Status (required)
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
... category 0..* CodeableConcept (USCDI+ Quality) Message category
Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Codes indicating the relative importance of a communication.
... medium 0..* CodeableConcept A channel of communication
Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
... subject Σ 0..1 Reference(US Quality Core Patient | Group) (USCDI+ Quality) Focus of message
... topic C 0..1 CodeableConcept (USCDI+ Quality) Description of the purpose/content
Binding: CommunicationTopic (1.0.0) (preferred)
.... 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:codeOptions C 0..1 canonical(ValueSet) (USCDI+ Quality) Url of a value set of candidate topics
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... about 0..* Reference(Resource) Resources that pertain to this communication
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... sent 0..1 dateTime (USCDI+ Quality) When sent
... received 0..1 dateTime When received
... recipient 0..* Reference(US Quality Core CareTeam | US Core Device Profile(9.0.0) | US Quality Core Organization | US Quality Core Patient | US Quality Core Practitioner | US Quality Core RelatedPerson | Group) Message recipient
... sender 0..1 Reference(US Core Device Profile(9.0.0) | US Quality Core Organization | US Quality Core Patient | US Quality Core Practitioner | US Quality Core RelatedPerson) Message sender
... reasonCode Σ 0..* CodeableConcept Indication for message
Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why was communication done?
... payload 0..* BackboneElement Message payload
.... 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
.... content[x] 1..1 Message part content
..... contentString string
..... contentAttachment Attachment
..... contentReference Reference(Resource)
... note 0..* Annotation Comments made about the communication

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Communication.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Communication.status Base required Positive Event Status 📦1.0.0-ballot This IG
Communication.statusReason Base example CommunicationNotDoneReason 📍4.0.1 FHIR Std.
Communication.category Base example CommunicationCategory 📍4.0.1 FHIR Std.
Communication.priority Base required Request priority 📍4.0.1 FHIR Std.
Communication.medium Base example ParticipationMode 📦3.0.0 THO v7.2
Communication.topic Base preferred CommunicationTopic 📍1.0.0 THO v5.5
Communication.reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
com-1 error Communication to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())
dom-2 error Communication If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Communication 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 Communication 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 Communication If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Communication 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()

Summary

Maturity: 4

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication C 0..* USQualityCoreCommunication A record of information transmitted from a sender to a receiver
Constraints: com-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code (USCDI+ Quality) preparation | in-progress | on-hold | stopped | completed
Binding: Positive Event Status (required)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Communication.status Base required Positive Event Status 📦1.0.0-ballot This IG

Constraints

Id Grade Path(s) Description Expression
com-1 error Communication to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())
dom-2 error Communication If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Communication 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 Communication 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 Communication If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Communication 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()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication 0..* USQualityCoreCommunication A record of information transmitted from a sender to a receiver
... status 1..1 code (USCDI+ Quality) preparation | in-progress | on-hold | stopped | completed
Binding: Positive Event Status (required)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Communication.status Base required Positive Event Status 📦1.0.0-ballot This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Communication C 0..* USQualityCoreCommunication A record of information transmitted from a sender to a receiver
Constraints: com-1
... 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 BindingsPurpose
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
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Unique identifier
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(Resource) Request fulfilled by this communication
... partOf Σ 0..* Reference(Resource) Part of this action
... inResponseTo 0..* Reference(Communication) Reply to
... status ?!Σ 1..1 code (USCDI+ Quality) preparation | in-progress | on-hold | stopped | completed
Binding: Positive Event Status (required)
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
... category 0..* CodeableConcept (USCDI+ Quality) Message category
Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Codes indicating the relative importance of a communication.
... medium 0..* CodeableConcept A channel of communication
Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
... subject Σ 0..1 Reference(US Quality Core Patient | Group) (USCDI+ Quality) Focus of message
... topic C 0..1 CodeableConcept (USCDI+ Quality) Description of the purpose/content
Binding: CommunicationTopic (1.0.0) (preferred)
.... 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:codeOptions C 0..1 canonical(ValueSet) (USCDI+ Quality) Url of a value set of candidate topics
URL: http://hl7.org/fhir/StructureDefinition/codeOptions
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... about 0..* Reference(Resource) Resources that pertain to this communication
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... sent 0..1 dateTime (USCDI+ Quality) When sent
... received 0..1 dateTime When received
... recipient 0..* Reference(US Quality Core CareTeam | US Core Device Profile(9.0.0) | US Quality Core Organization | US Quality Core Patient | US Quality Core Practitioner | US Quality Core RelatedPerson | Group) Message recipient
... sender 0..1 Reference(US Core Device Profile(9.0.0) | US Quality Core Organization | US Quality Core Patient | US Quality Core Practitioner | US Quality Core RelatedPerson) Message sender
... reasonCode Σ 0..* CodeableConcept Indication for message
Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why was communication done?
... payload 0..* BackboneElement Message payload
.... 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
.... content[x] 1..1 Message part content
..... contentString string
..... contentAttachment Attachment
..... contentReference Reference(Resource)
... note 0..* Annotation Comments made about the communication

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Communication.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Communication.status Base required Positive Event Status 📦1.0.0-ballot This IG
Communication.statusReason Base example CommunicationNotDoneReason 📍4.0.1 FHIR Std.
Communication.category Base example CommunicationCategory 📍4.0.1 FHIR Std.
Communication.priority Base required Request priority 📍4.0.1 FHIR Std.
Communication.medium Base example ParticipationMode 📦3.0.0 THO v7.2
Communication.topic Base preferred CommunicationTopic 📍1.0.0 THO v5.5
Communication.reasonCode Base example SNOMED CT Clinical Findings 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
com-1 error Communication to indicate what communication, either at least one coding in the topic or a codeOptions extension shall be provided topic.extension('http://hl7.org/fhir/StructureDefinition/codeOptions').exists() xor (topic.coding.exists() or topic.text.exists())
dom-2 error Communication If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Communication 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 Communication 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 Communication If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Communication 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()

Summary

Maturity: 4

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Element Conformance Indicators by Profile Layer

Badges identify the profile layer where each conformance indicator is first introduced. Indicators introduced in an earlier layer remain applicable in later derived profiles.

Element conformance indicators organized by the profile layer where they are first introduced
Profile element FHIR US Quality Core
status Mandatory USCDI+ Quality
category USCDI+ Quality
subject USCDI+ Quality
topic USCDI+ Quality
topic.extension:codeOptions USCDI+ Quality
sent USCDI+ Quality
payload.content[x] Mandatory

Cardinality note: “Mandatory” means the element has a minimum cardinality greater than zero. For nested elements, the cardinality indicator applies when the containing element is present.

Mandatory US Quality Core Server Search Parameters

The searches below are the focused set identified by US Quality Core as needed to retrieve USCDI+ Quality data for quality measurement and reporting. See the US Core FHIR RESTful Search API Requirements for detailed information on requirements by search parameter type.

See the US Quality Core Server CapabilityStatement for complete requirements for the underlying Communication resource and Search Requirement Selection for how this focused set was selected.

Servers supporting this profile SHALL support the following search parameters and search parameter combinations:

  1. SHALL support searching for all Communication resources for a patient using the subject search parameter.

    GET [base]/Communication?subject={Patient/}[id]

    Example:

    GET [base]/Communication?subject=Patient/example

    Implementation Notes: Fetches a bundle of US Quality Core CommunicationDone resources matching the specified search criteria. See how to search by reference.

    Rationale for inclusion: Supports subject-scoped retrieval of Communication resources for USCDI+ Quality workflows.

  2. SHALL support searching for all Communication resources for a patient using the combination of the subject and topic search parameters.

    • Including optional support for OR search on topic (e.g.topic={system|}[search_code],{system|}[search_code],...).

    GET [base]/Communication?subject={Patient/}[id]&topic={system|}[search_code]

    Example:

    GET [base]/Communication?subject=Patient/example&topic=http://terminology.hl7.org/CodeSystem/communication-topic|progress-update

    Implementation Notes: Fetches a bundle of US Quality Core CommunicationDone resources matching the specified search criteria. See how to search by reference and how to search by token.

    Rationale for inclusion: Supports subject-scoped retrieval of Communication resources filtered by topic for USCDI+ Quality workflows.

  3. SHALL support searching for all Communication resources for a patient using the combination of the subject and status search parameters.

    • Including optional support for OR search on status (e.g.status=[status],[status],...).

    GET [base]/Communication?subject={Patient/}[id]&status=[status]

    Example:

    GET [base]/Communication?subject=Patient/example&status=completed

    Implementation Notes: Fetches a bundle of US Quality Core CommunicationDone resources matching the specified search criteria. See how to search by reference and how to search by token.

    Rationale for inclusion: Supports subject-scoped retrieval of Communication resources filtered by status; status is used to indicate negation.