Generated Narrative: StructureDefinition ee-spd-practitioner-limited Name Flags Card. Type Description & Constraints Practitioner 0..* EEBasePractitioner(2.0.0) A person with a formal responsibility in the provisioning of healthcare or related services #xD; contained 0..0 Contained, inline Resources #xD; extension 0..0 Extension #xD; modifierExtension 0..0 Extension #xD; identifier 0..* Identifier Identifier of practitioner is health care specialist code provided by Terviseamet, consisting of one letter and 5 numbers #xD; id 0..0 Unique id for inter-element referencing #xD; extension 0..0 Extension #xD; use 0..0 usual | official | temp | secondary | old (If known) #xD; type 0..0 Description of identifier #xD; system 1..1 uri The namespace for the identifier value Fixed Value: https://fhir.ee/sid/pro/est/pho #xD; assigner 0..0 Organization that issued id (may be just text) #xD; name 1..1 HumanName First name and given name of healthcare professional #xD; id 0..0 Unique id for inter-element referencing #xD; extension 0..0 Extension #xD; use 0..0 usual | official | temp | nickname | anonymous | old | maiden #xD; text 0..0 Text representation of the full name #xD; prefix 0..0 Parts that come before the name #xD; suffix 0..0 Parts that come after the name #xD; period 0..0 Time period when name was/is in use #xD; telecom #xD; system 1..1 code phone | fax | email | pager | url | sms | other #xD; value 1..1 string The actual contact point details #xD; use 1..1 code home | work | temp | old | mobile - purpose of this contact point #xD; period 0..0 Time period when the contact point was/is in use #xD; gender 0..0 male | female | other | unknown #xD; birthDate 0..0 The date on which the practitioner was born #xD; deceased[x] 0..0 Indicates if the practitioner is deceased or not #xD; address 0..0 Address(es) of the practitioner that are not role specific (typically home address) #xD; photo 0..0 Image of the person #xD; Slices for qualification 0..* BackboneElement Qualifications, certifications, accreditations, licenses, training, etc. pertaining to the provision of care Slice: Unordered, Open by value:code.coding.system #xD; qualification:All Slices Content/Rules for all slices #xD; id 0..0 Unique id for inter-element referencing #xD; modifierExtension 0..0 Extension #xD; identifier 0..0 An identifier for this qualification for the practitioner #xD; code 1..1 CodeableConcept Coded representation of the qualification Binding: hl7VS-degreeLicenseCertificate (example): Siia siis vastav loend. #xD; id 0..0 Unique id for inter-element referencing #xD; extension 0..0 Extension #xD; coding #xD; id 0..0 Unique id for inter-element referencing #xD; extension 0..0 Extension #xD; version 0..0 Version of the system - if relevant #xD; userSelected 0..0 If this coding was chosen directly by the user #xD; text 0..0 Plain text representation of the concept #xD; issuer 0..0 Organization that regulates and issues the qualification #xD; qualification:speciality 0..* BackboneElement ERIALA. Erialade loendist. #xD; extension 0..* Extension Use this extension to represent exact THT code related to this specialty. #xD; code #xD; coding #xD; system 0..1 uri Identity of the terminology system Binding: https://fhir.ee/ValueSet/erialad (required) #xD; qualification:proffession 0..* BackboneElement KUTSE. #xD; code #xD; coding #xD; system 0..1 uri Identity of the terminology system Binding: https://fhir.ee/ValueSet/medre-tervishoiutootaja-kutse (required) #xD; communication 0..0 A language which may be used to communicate with the practitioner #xD; Documentation for this format
Tervishoiutöötaja ilma identifikaatorita või ainult THT koodiga. Healthcare professional with no identificator or only THT code, no personal identification code.
A person with a formal responsibility in the provisioning of healthcare or related services
A person who is directly or indirectly involved in the provisioning of healthcare or related services.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
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()
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()
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
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.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have 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.
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.
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.
Must have either extensions or value[x], not both
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Identifier of practitioner is health care specialist code provided by Terviseamet, consisting of one letter and 5 numbers
An identifier that applies to this person in this role.
Often, specific identities are assigned for the agent.
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Identifier.system is always case sensitive.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Eesti isikukood või tervishoiutöötaja kood
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Time period when id is/was valid for use
Time period during which identifier is/was valid for use.
Role.effectiveTime or implied by context
Organization that issued id (may be just text)
Organization that issued/manages the identifier.
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Whether this practitioner's record is in active use
Whether this practitioner's record is in active use.
If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.
Need to be able to mark a practitioner record as not to be used because it was created in error.
This resource is generally assumed to be active if no value is provided for the active element
This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
First name and given name of healthcare professional
The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate. In general, select the value to be used in the ResourceReference.display based on this: 1. There is more than 1 name 2. Use = usual 3. Period is current to the date of the usage 4. Use = official 5. Other order as decided by internal business rules.
The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.
./PreferredName (GivenNames, FamilyName, TitleCode)
usual | official | temp | nickname | anonymous | old | maiden
Applications can assume that a name is current unless it explicitly says that it is temporary or old.
Allows the appropriate name for a particular context of use to be selected from among a set of names.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
XPN.7, but often indicated by which field contains the name
Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.
Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.
The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.
Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).
Given names (not always 'first'). Includes middle names
If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.
Given Names appear in the correct order for presenting the name
Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.
Prefixes appear in the correct order for presenting the name
Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.
Suffixes appear in the correct order for presenting the name
Indicates the period of time when this name was valid for the named person.
Allows names to be placed in historical context.
A contact detail for the practitioner (that apply to all roles)
A contact detail for the practitioner, e.g. a telephone number or an email address.
Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.
Need to know how to reach a practitioner independent to any roles the practitioner may have.
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.
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.
phone | fax | email | pager | url | sms | other
Telecommunications form for contact point - what communications system is required to make use of the contact.
Telecommunications form for contact point.
The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Need to support legacy numbers that are not in a tightly controlled format.
home | work | temp | old | mobile - purpose of this contact point
Identifies the purpose for the contact point.
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Specify preferred order of use (1 = highest)
Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Ranks need not be unique. E.g. it's possible to have multiple contacts with rank=1. If the ranks have different systems or uses, this would be interpreted to mean "X is my most preferred phone number, Y is my most preferred email address" or "X is my preferred home email and Y is my preferred work email". If the system and use for equally-ranked contacts are the same, then the level of preference is equivalent for both repetitions. Ranks need not be sequential and not all repetitions must have a rank. For example, it's possible to have 4 contacts with ranks of 2, 5 and two with no rank specified. That would be interpreted to mean the first is preferred over the second and no preference stated for the remaining contacts.
Time period when the contact point was/is in use
Time period when the contact point was/is in use.
Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.
The gender of a person used for administrative purposes.
The date on which the practitioner was born
Indicates if the practitioner is deceased or not
Indicates if the practitioner is deceased or not.
If there's no value in the instance, it means there is no statement on whether or not the practitioner is deceased. Most systems will interpret the absence of a value as a sign of the person being alive.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
Address(es) of the practitioner that are not role specific (typically home address)
Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.
The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).
The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.
Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.
./ImageURI (only supports the URI reference)
Qualifications, certifications, accreditations, licenses, training, etc. pertaining to the provision of care
The official qualifications, certifications, accreditations, training, licenses (and other types of educations/skills/capabilities) that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board of licensure authorizing the practitioner to practice medicine within a certain locality.
The PractitionerRole.specialty defines the functional role that they are practicing at a given organization or location. Those specialties may or might not require a qualification, and are not defined on the practitioner.
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
An identifier for this qualification for the practitioner
An identifier that applies to this person's qualification.
Often, specific identities are assigned for the qualification.
Coded representation of the qualification
Coded representation of the qualification.
A reference to a code defined by a terminology system.
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.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
The identification of the code system that defines the meaning of the symbol in the code.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Plain text representation of the concept
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.
Very often the text is the same as a displayName of one of the codings.
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.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Period during which the qualification is valid
Period during which the qualification is valid.
Qualifications are often for a limited period of time, and can be revoked.
./Qualifications.StartDate and ./Qualifications.EndDate
Organization that regulates and issues the qualification
Organization that regulates and issues the qualification.
Use this extension to represent exact THT code related to this specialty.
A language which may be used to communicate with the practitioner
A language which may be used to communicate with the practitioner, often for correspondence/administrative purposes. The `PractitionerRole.communication` property should be used for publishing the languages that a practitioner is able to communicate with patients (on a per Organization/Role basis).
If no language is specified, this *implies* that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple Practitioner.Communication associations. For animals, language is not a relevant field, and should be absent from the instance.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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).
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
The language code used to communicate with the practitioner
The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-AU" for Australian English.
The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.
player[classCode=PSN|ANM and determinerCode=INSTANCE]/languageCommunication/code
Indicates whether or not the person prefers this language (over other languages he masters up a certain level).
This language is specifically identified for communicating directly with the practitioner (typically un-related to patient communications).
People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.