IKNL PZP STU3
1.0.0-alpha1 - consultation International flag

IKNL PZP STU3, published by IKNL. This guide is not an authorized publication; it is the continuous build for version 1.0.0-alpha1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IKNL/PZP-FHIR-STU3/ and changes regularly. See the Directory of published versions

Resource Profile: ACPCommunication - Detailed Descriptions

Draft as of 2025-10-27

Definitions for the ACP-Communication resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Communication
Definition

An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency was notified about a reportable condition.

ShortA record of information transmitted from a sender to a receiver
Control0..*
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
com-1: Not Done Reason can only be specified if NotDone is "true" (notDone or notDoneReason.exists().not())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
com-1: Not Done Reason can only be specified if NotDone is "true" (notDone or notDoneReason.exists().not())
2. Communication.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

ShortA set of rules under which this content was created
Comments

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. Communication.modifierExtension
Definition

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. Usually modifier elements provide negation or qualification. In order 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.

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
6. Communication.status
Definition

The status of the transmission.

Shortpreparation | in-progress | suspended | aborted | completed | entered-in-error
Comments

This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.

Control1..1
BindingThe codes SHALL be taken from EventStatushttp://hl7.org/fhir/ValueSet/event-status|3.0.2
(required to http://hl7.org/fhir/ValueSet/event-status|3.0.2)

The status of the communication.

Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
8. Communication.notDone
Definition

If true, indicates that the described communication event did not actually occur.

ShortCommunication did not occur
Comments

This element is labeled as a modifier because it marks the communication as a communication that did not occur. The more attributes are populated, the more constrained the negated statement is.

Control0..1
Typeboolean
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Creating a Communication where notDone is true is intended for situations where there's a need for a specific statement in the record about something not being done. If the need is merely to indicate that a request wasn't fulfilled, that should be handled using Task.

10. Communication.subject
Definition

The patient or group that was the focus of this communication.

ShortFocus of message
Control0..1
TypeReference(Patient, Patient, Group)
Summarytrue
Alternate Namespatient
12. Communication.recipient
Definition

The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient.  Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time).

ShortMessage recipient
Control0..*
TypeReference(Patient, Device, Organization, Patient, Practitioner, RelatedPerson, Group)
14. Communication.topic
Definition

The resources which were responsible for or related to producing this communication.

ShortFocal resources
Comments

For information patient about own responsibility the following text may be added to the topic.text element: Informing the patient about their own responsibility to discuss these treatment agreements with relatives.

Control0..*
TypeReference(Resource)
16. Communication.sent
Definition

The time when this communication was sent.

ShortWhen sent
Comments

Indicate the date and preferrably time when the communication was sent

Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
18. Communication.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

ShortMessage sender
Control0..1
TypeReference(HealthProfessional Practitioner, Device, Organization, Patient, Practitioner, RelatedPerson)
20. Communication.reasonCode
Definition

The reason or justification for the communication.

ShortIndication for message
Comments

Textual reasons can be caprued using reasonCode.text.

Control10..1*
BindingFor example codes, see SNOMED CT Clinical Findingshttp://hl7.org/fhir/ValueSet/clinical-findings|3.0.2
(example to http://hl7.org/fhir/ValueSet/clinical-findings|3.0.2)

Codes for describing reasons for the occurrence of a communication.

TypeCodeableConcept
Summarytrue
Pattern Value{
  "coding" : [{
    "system" : "http://snomed.info/sct",
    "code" : "713603004"
  }]
}

Guidance on how to interpret the contents of this table can be foundhere

0. Communication
2. Communication.subject
TypeReference(Patient)
4. Communication.recipient
TypeReference(Patient)
6. Communication.topic
Comments

For information patient about own responsibility the following text may be added to the topic.text element: Informing the patient about their own responsibility to discuss these treatment agreements with relatives.

8. Communication.sent
Comments

Indicate the date and preferrably time when the communication was sent

10. Communication.sender
TypeReference(HealthProfessional Practitioner)
12. Communication.reasonCode
Control1..1
Pattern Value{
  "coding" : [{
    "system" : "http://snomed.info/sct",
    "code" : "713603004"
  }]
}

Guidance on how to interpret the contents of this table can be foundhere

0. Communication
Definition

An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency was notified about a reportable condition.

ShortA record of information transmitted from a sender to a receiver
Control0..*
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
dom-4: 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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
com-1: Not Done Reason can only be specified if NotDone is "true" (notDone or notDoneReason.exists().not())
2. Communication.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. Communication.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Summarytrue
6. Communication.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

ShortA set of rules under which this content was created
Comments

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
8. Communication.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

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).

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Common Languages
(extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

A human language.

Additional BindingsPurpose
All LanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
10. Communication.text
Definition

A human-readable narrative that contains a summary of the resource, and may 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.

ShortText summary of the resource, for human interpretation
Comments

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 in formation is added later.

Control0..1
This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
12. Communication.contained
Definition

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.

ShortContained, inline Resources
Comments

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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
14. Communication.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

ShortAdditional Content defined by implementations
Comments

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
16. Communication.modifierExtension
Definition

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. Usually modifier elements provide negation or qualification. In order 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.

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
18. Communication.identifier
Definition

Identifiers associated with this Communication that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

ShortUnique identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
20. Communication.definition
Definition

A protocol, guideline, or other definition that was adhered to in whole or in part by this communication event.

ShortInstantiates protocol or definition
Control0..*
TypeReference(PlanDefinition, ActivityDefinition)
Summarytrue
22. Communication.basedOn
Definition

An order, proposal or plan fulfilled in whole or in part by this Communication.

ShortRequest fulfilled by this communication
Comments

This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ReferralRequest, MedicationRequest, etc.

Control0..*
TypeReference(Resource)
Summarytrue
Alternate Namesfulfills
24. Communication.partOf
Definition

Part of this action.

ShortPart of this action
Control0..*
TypeReference(Resource)
Summarytrue
Alternate Namescontainer
26. Communication.status
Definition

The status of the transmission.

Shortpreparation | in-progress | suspended | aborted | completed | entered-in-error
Comments

This element is labeled as a modifier because the status contains the codes aborted and entered-in-error that mark the communication as not currently valid.

Control1..1
BindingThe codes SHALL be taken from EventStatus
(required to http://hl7.org/fhir/ValueSet/event-status|3.0.2)

The status of the communication.

Typecode
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
28. Communication.notDone
Definition

If true, indicates that the described communication event did not actually occur.

ShortCommunication did not occur
Comments

This element is labeled as a modifier because it marks the communication as a communication that did not occur. The more attributes are populated, the more constrained the negated statement is.

Control0..1
Typeboolean
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Creating a Communication where notDone is true is intended for situations where there's a need for a specific statement in the record about something not being done. If the need is merely to indicate that a request wasn't fulfilled, that should be handled using Task.

30. Communication.notDoneReason
Definition

Describes why the communication event did not occur in coded and/or textual form.

ShortWhy communication did not occur
Control0..1
This element is affected by the following invariants: com-1
BindingFor example codes, see CommunicationNotDoneReason
(example to http://hl7.org/fhir/ValueSet/communication-not-done-reason|3.0.2)

Codes for the reason why a communication was not done.

TypeCodeableConcept
Summarytrue
32. Communication.category
Definition

The type of message conveyed such as alert, notification, reminder, instruction, etc.

ShortMessage category
Comments

There may be multiple axes of categorization and one communication may serve multiple purposes.

Control0..*
BindingFor example codes, see CommunicationCategory
(example to http://hl7.org/fhir/ValueSet/communication-category|3.0.2)

Codes for general categories of communications such as alerts, instruction, etc.

TypeCodeableConcept
34. Communication.medium
Definition

A channel that was used for this communication (e.g. email, fax).

ShortA channel of communication
Control0..*
BindingFor example codes, see ParticipationMode|2016-11-11
(example to http://hl7.org/fhir/ValueSet/v3-ParticipationMode|2016-11-11)

Codes for communication mediums such as phone, fax, email, in person, etc.

TypeCodeableConcept
36. Communication.subject
Definition

The patient or group that was the focus of this communication.

ShortFocus of message
Control0..1
TypeReference(Patient)
Summarytrue
Alternate Namespatient
38. Communication.recipient
Definition

The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient.  Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time).

ShortMessage recipient
Control0..*
TypeReference(Patient)
40. Communication.topic
Definition

The resources which were responsible for or related to producing this communication.

ShortFocal resources
Comments

For information patient about own responsibility the following text may be added to the topic.text element: Informing the patient about their own responsibility to discuss these treatment agreements with relatives.

Control0..*
TypeReference(Resource)
42. Communication.context
Definition

The encounter within which the communication was sent.

ShortEncounter or episode leading to message
Control0..1
TypeReference(Encounter, EpisodeOfCare)
Summarytrue
Alternate Namesencounter
44. Communication.sent
Definition

The time when this communication was sent.

ShortWhen sent
Comments

Indicate the date and preferrably time when the communication was sent

Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
46. Communication.received
Definition

The time when this communication arrived at the destination.

ShortWhen received
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. Communication.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication.

ShortMessage sender
Control0..1
TypeReference(HealthProfessional Practitioner)
50. Communication.reasonCode
Definition

The reason or justification for the communication.

ShortIndication for message
Comments

Textual reasons can be caprued using reasonCode.text.

Control1..1
BindingFor example codes, see SNOMED CT Clinical Findings
(example to http://hl7.org/fhir/ValueSet/clinical-findings|3.0.2)

Codes for describing reasons for the occurrence of a communication.

TypeCodeableConcept
Summarytrue
Pattern Value{
  "coding" : [{
    "system" : "http://snomed.info/sct",
    "code" : "713603004"
  }]
}
52. Communication.reasonReference
Definition

Indicates another resource whose existence justifies this communication.

ShortWhy was communication done?
Control0..*
TypeReference(Condition, Observation)
Summarytrue
54. Communication.payload
Definition

Text, attachment(s), or resource(s) that was communicated to the recipient.

ShortMessage payload
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
56. Communication.payload.id
Definition

unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Shortxml:id (or equivalent in JSON)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
XML FormatIn the XML format, this property is represented as an attribute.
58. Communication.payload.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

ShortAdditional Content defined by implementations
Comments

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
60. Communication.payload.modifierExtension
Definition

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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Summarytrue
Alternate Namesextensions, user content, modifiers
62. Communication.payload.content[x]
Definition

A communicated content (or for multi-part communications, one portion of the communication).

ShortMessage part content
Control1..1
TypeChoice of: string, Attachment, Reference(Resource)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
64. Communication.note
Definition

Additional notes or commentary about the communication by the sender, receiver or other interested parties.

ShortComments made about the communication
Control0..*
TypeAnnotation