Medication Scheme Implementation Guide
1.0.0 - draft Estonia flag

Medication Scheme Implementation Guide, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-medication-scheme/ and changes regularly. See the Directory of published versions

Resource Profile: EETISCommunication - Detailed Descriptions

Draft as of 2025-03-12

Definitions for the ee-tis-communication resource profile.

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

0. Communication
Definition

Kommentaar


A clinical or business level record of information being transmitted or shared; e.g. an alert that was sent to a responsible provider, a public health agency communication to a provider/reporter in response to a case report for a reportable condition.

ShortCommentA clinical or business level record of information being transmitted or shared
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Communication.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

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. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. 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 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 managable, 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).

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 Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Must Supportfalse
Summarytrue
Requirements

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.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Communication.identifier
Definition

Kommentaari ID


Business identifiers assigned to this communication by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

ShortID of the commentUnique identifier
Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supportfalse
Summarytrue
Requirements

Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Communication.status
Definition

Kasutusel 2 staatust LISATUD=completed, KUSTUTATUD=stopped. Kui tegu on muutmisega, tuleb see välja note.time elemendi muutmise aja ja teksti kaudu.


The status of the transmission.

ShortStatus of the comment can be completed(LISATUD) or stopped(KUSTUTATUD). If comment is changed the note element is used.preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
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|5.0.0
(required to http://hl7.org/fhir/ValueSet/event-status|5.0.0)

The status of the communication.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Communication.category
Definition

Kommentaari tüüp, nt neerufunktsiooni mõjutav ravimi puhul on koodiks |alert|


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

ShortThe type of comment this is. Codes |alert| or |notification| are usedMessage category
Comments

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

Control10..1*
BindingFor example codes, see CommunicationCategoryhttp://hl7.org/fhir/ValueSet/communication-category
(example to http://hl7.org/fhir/ValueSet/communication-category)

|alert| is used when there is a renal failure of some degree and the health care professional needs to pay more attention to dosage


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

TypeCodeableConcept
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Communication.category.text
Definition

C/D. Siia tuleb hoiatus, kui ravim on neerutoksiline. Kui on tegu muu kommentaariga siis see väli on tühi


A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

ShortDescription of the alertPlain text representation of the concept
Comments

Very often the text is the same as a displayName of one of the codings.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Communication.about
Definition

Ravimiskeemi rida, mille kohta kommentaar on tehtud


Other resources that pertain to this communication and to which this communication should be associated.

ShortRelated MedicationStatement the comment is aboutResources that pertain to this communication
Comments

Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.

Control10..1*
TypeReference(MedicationStatement, Resource)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Communication.sent
Definition

Kommentaari lisamise aeg


The time when this communication was sent.

ShortWhen the comment was added to the MedicationStatementWhen sent
Control10..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Communication.sender
Definition

Tervishoiutöötaja, kes lisas ravimiskeemi reale kommentaari


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

ShortPractitioner who added the commentWho shares the information
Control10..1
TypeReference(EETISPractitioner, EETISPractitionerRole, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService, Endpoint, CareTeam)
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Communication.reason
Definition

Viide ravimile, ka toimeaine ja tugevus, mille kohta kommentaar on tehtud


The reason or justification for the communication.

ShortReference to a certain medication, its strenght and active ingredient this comment is aboutIndication for message
Comments

Textual reasons can be captured using reason.concept.text.

Control0..*
BindingFor example codes, see SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findings
(example to http://hl7.org/fhir/ValueSet/clinical-findings)

Codes for describing reasons for the occurrence of a communication.

TypeCodeableReference(Medication, Resource)
Is Modifierfalse
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Communication.payload
Definition

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

ShortMessage payload
Control10..1*
TypeBackboneElement
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. 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 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 managable, 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).

ShortExtensions that cannot be ignored even if unrecognized
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 Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
28. Communication.payload.content[x]
Definition

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

ShortMessage part content
Comments

The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.

If the content isn't codified, contentCodeableConcept.text can be used.

When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.

Control1..1
TypeChoice of: Attachment, Reference(Resource), CodeableConcept
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Communication.payload.content[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 30. Communication.payload.content[x]:contentCodeableConcept
    Slice NamecontentCodeableConcept
    Definition

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

    ShortMessage part content
    Comments

    The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.

    If the content isn't codified, contentCodeableConcept.text can be used.

    When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.

    Control01..1
    TypeCodeableConcept, Reference(Resource), Attachment
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Communication.payload.content[x]:contentCodeableConcept.text
    Definition

    Kommentaari sisu vabatekstina


    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

    ShortComment about the MedicationStatement in free form textPlain text representation of the concept
    Comments

    Very often the text is the same as a displayName of one of the codings.

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

    0. Communication
    Definition

    Kommentaar

    ShortComment
    2. Communication.identifier
    Definition

    Kommentaari ID

    ShortID of the comment
    NoteThis is a business identifier, not a resource identifier (see discussion)
    4. Communication.status
    Definition

    Kasutusel 2 staatust LISATUD=completed, KUSTUTATUD=stopped. Kui tegu on muutmisega, tuleb see välja note.time elemendi muutmise aja ja teksti kaudu.

    ShortStatus of the comment can be completed(LISATUD) or stopped(KUSTUTATUD). If comment is changed the note element is used.
    6. Communication.category
    Definition

    Kommentaari tüüp, nt neerufunktsiooni mõjutav ravimi puhul on koodiks |alert|

    ShortThe type of comment this is. Codes |alert| or |notification| are used
    Control1..1
    BindingFor example codes, see CommunicationCategory
    (example to http://hl7.org/fhir/ValueSet/communication-category)

    |alert| is used when there is a renal failure of some degree and the health care professional needs to pay more attention to dosage

    8. Communication.category.text
    Definition

    C/D. Siia tuleb hoiatus, kui ravim on neerutoksiline. Kui on tegu muu kommentaariga siis see väli on tühi

    ShortDescription of the alert
    10. Communication.about
    Definition

    Ravimiskeemi rida, mille kohta kommentaar on tehtud

    ShortRelated MedicationStatement the comment is about
    Control1..1
    TypeReference(MedicationStatement)
    12. Communication.sent
    Definition

    Kommentaari lisamise aeg

    ShortWhen the comment was added to the MedicationStatement
    Control1..?
    14. Communication.sender
    Definition

    Tervishoiutöötaja, kes lisas ravimiskeemi reale kommentaari

    ShortPractitioner who added the comment
    Control1..?
    TypeReference(EETISPractitioner, EETISPractitionerRole)
    16. Communication.reason
    Definition

    Viide ravimile, ka toimeaine ja tugevus, mille kohta kommentaar on tehtud

    ShortReference to a certain medication, its strenght and active ingredient this comment is about
    TypeCodeableReference(Medication)
    18. Communication.payload
    Control1..1
    20. Communication.payload.content[x]
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on Communication.payload.content[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 22. Communication.payload.content[x]:contentCodeableConcept
      Slice NamecontentCodeableConcept
      Control0..1
      TypeCodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      24. Communication.payload.content[x]:contentCodeableConcept.text
      Definition

      Kommentaari sisu vabatekstina

      ShortComment about the MedicationStatement in free form text
      Control1..?
      26. Communication.note
      28. Communication.note.time
      Definition

      Kommentaari muutmise aeg

      ShortTime when the comment was changed.
      Control1..?
      30. Communication.note.text
      Definition

      Kommentaari muutmise põhjendus

      ShortWhy the comment was changed

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

      0. Communication
      Definition

      Kommentaar

      ShortComment
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      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

      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

      Control0..1
      Typeid
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      4. Communication.meta
      Definition

      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.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      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
      BindingThe codes SHALL be taken from AllLanguages
      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

      IETF language tag for a human language

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Communication.text
      Definition

      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.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have a 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.

      Control0..1
      This element is affected by the following invariants: dom-6
      TypeNarrative
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Communication.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      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. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

      Control0..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      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. To make the use of extensions safe and managable, 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.

      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
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      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 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 managable, 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).

      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 Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Must Supportfalse
      Summarytrue
      Requirements

      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.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Communication.identifier
      Definition

      Kommentaari ID

      ShortID of the comment
      Comments

      This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Requirements

      Allows identification of the communication as it is known by various participating systems and in a way that remains consistent across servers.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Communication.instantiatesCanonical
      Definition

      The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.

      ShortInstantiates FHIR protocol or definition
      Control0..*
      Typecanonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Communication.instantiatesUri
      Definition

      The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.

      ShortInstantiates external protocol or definition
      Comments

      This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

      Control0..*
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. 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, ServiceRequest, MedicationRequest, etc.

      Control0..*
      TypeReference(Resource)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Alternate Namesfulfills
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Communication.partOf
      Definition

      A larger event (e.g. Communication, Procedure) of which this particular communication is a component or step.

      ShortPart of referenced event (e.g. Communication, Procedure)
      Comments

      The event the communication was part of - e.g. if you disclosed as "part" of counselling, it would be partOf that Procedure.

      Control0..*
      TypeReference(Resource)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Alternate Namescontainer
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Communication.inResponseTo
      Definition

      Prior communication that this communication is in response to.

      ShortReply to
      Control0..*
      TypeReference(Communication)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Communication.status
      Definition

      Kasutusel 2 staatust LISATUD=completed, KUSTUTATUD=stopped. Kui tegu on muutmisega, tuleb see välja note.time elemendi muutmise aja ja teksti kaudu.

      ShortStatus of the comment can be completed(LISATUD) or stopped(KUSTUTATUD). If comment is changed the note element is used.
      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|5.0.0)

      The status of the communication.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Communication.statusReason
      Definition

      Captures the reason for the current state of the Communication.

      ShortReason for current status
      Comments

      This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

      Control0..1
      BindingFor example codes, see CommunicationNotDoneReason
      (example to http://hl7.org/fhir/ValueSet/communication-not-done-reason)

      Codes for the reason why a communication did not happen.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Alternate NamesSuspended Reason, Cancelled Reason
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Communication.category
      Definition

      Kommentaari tüüp, nt neerufunktsiooni mõjutav ravimi puhul on koodiks |alert|

      ShortThe type of comment this is. Codes |alert| or |notification| are used
      Comments

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

      Control1..1
      BindingFor example codes, see CommunicationCategory
      (example to http://hl7.org/fhir/ValueSet/communication-category)

      |alert| is used when there is a renal failure of some degree and the health care professional needs to pay more attention to dosage

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Communication.category.id
      Definition

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

      ShortUnique id for inter-element referencing
      Control0..1
      This element is affected by the following invariants: ele-1
      Typeid
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      38. Communication.category.extension
      Definition

      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 managable, 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.

      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
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Communication.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 40. Communication.category.coding
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control0..*
        TypeCoding
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Communication.category.text
        Definition

        C/D. Siia tuleb hoiatus, kui ravim on neerutoksiline. Kui on tegu muu kommentaariga siis see väli on tühi

        ShortDescription of the alert
        Comments

        Very often the text is the same as a displayName of one of the codings.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Communication.priority
        Definition

        Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.

        Shortroutine | urgent | asap | stat
        Comments

        Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.

        Control0..1
        BindingThe codes SHALL be taken from RequestPriority
        (required to http://hl7.org/fhir/ValueSet/request-priority|5.0.0)

        Codes indicating the relative importance of a communication.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Meaning if MissingIf missing, this communication should be treated with normal priority
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. 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
        (example to http://terminology.hl7.org/ValueSet/v3-ParticipationMode)

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

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Communication.subject
        Definition

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

        ShortFocus of message
        Control0..1
        TypeReference(Patient, Group)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Alternate Namespatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Communication.topic
        Definition

        Description of the purpose/content, similar to a subject line in an email.

        ShortDescription of the purpose/content
        Comments

        Communication.topic.text can be used without any codings.

        Control0..1
        BindingFor example codes, see CommunicationTopic
        (example to http://hl7.org/fhir/ValueSet/communication-topic)

        Codes describing the purpose or content of the communication.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Communication.about
        Definition

        Ravimiskeemi rida, mille kohta kommentaar on tehtud

        ShortRelated MedicationStatement the comment is about
        Comments

        Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.

        Control1..1
        TypeReference(MedicationStatement)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Communication.encounter
        Definition

        The Encounter during which this Communication was created or to which the creation of this record is tightly associated.

        ShortThe Encounter during which this Communication was created
        Comments

        This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

        Control0..1
        TypeReference(Encounter)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Communication.sent
        Definition

        Kommentaari lisamise aeg

        ShortWhen the comment was added to the MedicationStatement
        Control1..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Communication.received
        Definition

        The time when this communication arrived at the destination.

        ShortWhen received
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Communication.recipient
        Definition

        The entity (e.g. person, organization, clinical information system, care team or device) which is the target of the communication.

        ShortWho the information is shared with
        Comments

        If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).

        Control0..*
        TypeReference(CareTeam, Device, Group, HealthcareService, Location, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Endpoint)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Communication.sender
        Definition

        Tervishoiutöötaja, kes lisas ravimiskeemi reale kommentaari

        ShortPractitioner who added the comment
        Control1..1
        TypeReference(EETISPractitioner, EETISPractitionerRole)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Communication.reason
        Definition

        Viide ravimile, ka toimeaine ja tugevus, mille kohta kommentaar on tehtud

        ShortReference to a certain medication, its strenght and active ingredient this comment is about
        Comments

        Textual reasons can be captured using reason.concept.text.

        Control0..*
        BindingFor example codes, see SNOMEDCTClinicalFindings
        (example to http://hl7.org/fhir/ValueSet/clinical-findings)

        Codes for describing reasons for the occurrence of a communication.

        TypeCodeableReference(Medication)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Communication.payload
        Definition

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

        ShortMessage payload
        Control1..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. 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.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        70. Communication.payload.extension
        Definition

        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 managable, 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.

        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
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        72. 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 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 managable, 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).

        ShortExtensions that cannot be ignored even if unrecognized
        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 Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        74. Communication.payload.content[x]
        Definition

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

        ShortMessage part content
        Comments

        The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.

        If the content isn't codified, contentCodeableConcept.text can be used.

        When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.

        Control1..1
        TypeChoice of: Attachment, Reference(Resource), CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Communication.payload.content[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 76. Communication.payload.content[x]:contentCodeableConcept
          Slice NamecontentCodeableConcept
          Definition

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

          ShortMessage part content
          Comments

          The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.

          If the content isn't codified, contentCodeableConcept.text can be used.

          When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.

          Control0..1
          TypeCodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. Communication.payload.content[x]:contentCodeableConcept.id
          Definition

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

          ShortUnique id for inter-element referencing
          Control0..1
          This element is affected by the following invariants: ele-1
          Typeid
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          80. Communication.payload.content[x]:contentCodeableConcept.extension
          Definition

          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 managable, 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.

          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
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Communication.payload.content[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 82. Communication.payload.content[x]:contentCodeableConcept.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. Communication.payload.content[x]:contentCodeableConcept.text
            Definition

            Kommentaari sisu vabatekstina

            ShortComment about the MedicationStatement in free form text
            Comments

            Very often the text is the same as a displayName of one of the codings.

            Control1..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            86. 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
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. Communication.note.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..1
            This element is affected by the following invariants: ele-1
            Typeid
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            90. Communication.note.extension
            Definition

            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 managable, 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.

            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
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Communication.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 92. Communication.note.author[x]
              Definition

              The individual responsible for making the annotation.

              ShortIndividual responsible for the annotation
              Comments

              Organization is used when there's no need for specific attribution as to who made the comment.

              Control0..1
              TypeChoice of: Reference(Practitioner, PractitionerRole, Patient, RelatedPerson, Organization), string
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              94. Communication.note.time
              Definition

              Kommentaari muutmise aeg

              ShortTime when the comment was changed.
              Control1..1
              TypedateTime
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              96. Communication.note.text
              Definition

              Kommentaari muutmise põhjendus

              ShortWhy the comment was changed
              Control1..1
              Typemarkdown
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))