New Zealand ICP Implementation Guide
1.0.0 - draft

New Zealand ICP Implementation Guide, published by Accident Compensation Corporation. 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/acc-fhir-publisher/icp/ and changes regularly. See the Directory of published versions

Resource Profile: IcpCaseModify - Detailed Descriptions

Active as of 2022-11-20

Definitions for the acc-icp-case-modify resource profile.

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

0. EpisodeOfCare
Invariantsactive-status-invariant: The status attribute must be set to 'active'. (status = 'active')
2. EpisodeOfCare.contained
Control1..?
4. EpisodeOfCare.contained:patient
Slice Namepatient
Control1..1
TypePatient(ACC ICP Patient)
6. EpisodeOfCare.extension
Control2..3
8. EpisodeOfCare.extension:service-bundle-change
Slice Nameservice-bundle-change
ShortThe updated ICP service bundle for the treatment.
Control1..1
TypeExtension(ICP Service Bundle Change) (Complex Extension)
10. EpisodeOfCare.extension:exceptional-funding
Slice Nameexceptional-funding
ShortIndicates if exceptionalfunding is required for this treatment and the funding type.
Control0..1
TypeExtension(Exceptional Funding) (Complex Extension)
12. EpisodeOfCare.status
Definition

The Status of the ICP case (must be Active).

14. EpisodeOfCare.type
Control0..0
16. EpisodeOfCare.period
Control0..0

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

0. EpisodeOfCare
Definition

An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time.

ShortAn association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesCase Program Problem
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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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())
end-date-when-active-invariant: End date is not allowed when status is active (status = 'active' implies period.end.empty())
end-date-when-finished-invariant: End date is required when status is finished (status = 'finished' implies period.end.exists())
active-status-invariant: The status attribute must be set to 'active'. (status = 'active')
2. EpisodeOfCare.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 it's 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 it's meaning or interpretation
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()))
4. EpisodeOfCare.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control10..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
SlicingThis element introduces a set of slices on EpisodeOfCare.contained. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • profile @ $this
  • 6. EpisodeOfCare.contained:patient
    Slice Namepatient
    Definition

    Demographics and other administrative information about an individual or animal receiving care or other health-related services.


    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

    ShortInformation about an individual or animal receiving health care servicesContained, 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.

    Control10..1*
    TypePatientResource(ACC ICP Patient)
    Is Modifierfalse
    Summaryfalse
    Alternate NamesSubjectOfCare Client Resident, inline resources, anonymous resources, contained resources
    8. EpisodeOfCare.extension
    Definition

    An Extension


    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 manageable, 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.

    ShortExtensionAdditional 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.

    Control20..3*
    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 EpisodeOfCare.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 10. EpisodeOfCare.extension:acc-providerid
      Slice Nameacc-providerid
      Definition

      This represents the person submitting this form to ACC. It should take the form of their ACC Provider ID.

      ShortThe ACC provider ID associated with the ICP case
      Control1..1
      This element is affected by the following invariants: ele-1
      TypeExtension(ACC Provider ID) (Extension Type: string)
      Is Modifierfalse
      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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      12. EpisodeOfCare.extension:service-bundle-change
      Slice Nameservice-bundle-change
      Definition

      An extension to capture the reason for a change in the ICP Service Bundle.

      ShortThe updated ICP service bundle for the treatment.
      Control1..1
      TypeExtension(ICP Service Bundle Change) (Complex Extension)
      Is Modifierfalse
      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())
      14. EpisodeOfCare.extension:exceptional-funding
      Slice Nameexceptional-funding
      Definition

      Indicates if exceptional is required for this treatment.

      ShortIndicates if exceptionalfunding is required for this treatment and the funding type.
      Control0..1
      TypeExtension(Exceptional Funding) (Complex Extension)
      Is Modifierfalse
      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. EpisodeOfCare.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      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
      Summaryfalse
      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. EpisodeOfCare.identifier
      Definition

      The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

      ShortBusiness Identifier(s) relevant for this EpisodeOfCare
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control10..1*
      TypeIdentifier
      Is Modifierfalse
      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 EpisodeOfCare.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • 20. EpisodeOfCare.identifier:icpclaimnumber
        Slice Nameicpclaimnumber
        Definition

        The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

        ShortThe ACC 45 number to be used in combination with the contained patient's date of birth, as the ICP case idenfitier.Business Identifier(s) relevant for this EpisodeOfCare
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control10..1*
        TypeIdentifier
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. EpisodeOfCare.identifier:icpclaimnumber.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..01
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        24. EpisodeOfCare.identifier:icpclaimnumber.extension
        Definition

        An Extension


        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 manageable, 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.

        ShortExtensionAdditional 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..0*
        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 EpisodeOfCare.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 26. EpisodeOfCare.identifier:icpclaimnumber.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. EpisodeOfCare.identifier:icpclaimnumber.system
          Definition

          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

          ShortThe namespace for the identifier value
          Comments

          Identifier.system is always case sensitive.

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

          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.

          Fixed Valuehttps://standards.digital.health.nz/ns/acc-45-number
          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. EpisodeOfCare.identifier:icpclaimnumber.value
          Definition

          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

          ShortThe ACC 45 number.The value that is unique
          Comments

          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 Rendered Value extension. 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.

          Control10..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Example<br/><b>General</b>:123456
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          acc-claim-number: The claim number format is invalid; it must be in the form A999999, AA99999, 9999AAA or 99999AA, where A is any capital letter, 9 is any single digit, and there are 7 characters altogether. ($this.toString().matches('^[A-Z][0-9]{6}$|^[A-Z]{2}[0-9]{5}$|^[0-9]{4}[A-Z]{3}$|^[0-9]{5}[A-Z]{2}$'))
          32. EpisodeOfCare.identifier:icpclaimnumber.period
          Definition

          Time period during which identifier is/was valid for use.

          ShortTime period when id is/was valid for use
          Control0..01
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. EpisodeOfCare.identifier:icpclaimnumber.assigner
          Definition

          Organization that issued/manages the identifier.

          ShortOrganization that issued id (may be just text)
          Comments

          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.

          Control0..01
          TypeReference(Organization)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. EpisodeOfCare.status
          Definition

          The Status of the ICP case (must be Active).


          planned | waitlist | active | onhold | finished | cancelled.

          Shortactive | finishedplanned | waitlist | active | onhold | finished | cancelled | entered-in-error
          Comments

          This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid.

          Control1..1
          BindingThe codes SHALL be taken from Statushttp://hl7.org/fhir/ValueSet/episode-of-care-status|4.0.1
          (required to http://hl7.org.nz/fhir/ValueSet/acc-icp-episodeofcare-status)
          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
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. EpisodeOfCare.statusHistory
          Definition

          The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource).

          ShortPast list of status codes (the current status may be included to cover the start date of the status)
          Control0..0*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          43. EpisodeOfCare.type
          Definition

          A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care.

          ShortThe type of ICP service. Currently only musculoskeletal (msk) is allowed, with more to be added in the future, e.g. concussion.Type/class - e.g. specialist referral, disease management
          Comments

          The type can be very important in processing as this could be used in determining if the EpisodeOfCare is relevant to specific government reporting, or other types of classifications.

          Control0..0*
          BindingFor example codes, see EpisodeOfCareTypehttp://hl7.org/fhir/ValueSet/episodeofcare-type
          (example to http://hl7.org/fhir/ValueSet/episodeofcare-type)

          The type of the episode of care.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. EpisodeOfCare.diagnosis
          Definition

          The list of diagnosis relevant to this episode of care.

          ShortThe list of diagnosis relevant to this episode of care
          Control0..0*
          TypeBackboneElement
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. EpisodeOfCare.patient
          Definition

          The patient who is the focus of this episode of care.

          ShortThe patient who is the focus of this episode of care
          Control1..1
          TypeReference(ACC ICP Patient, Patient)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. EpisodeOfCare.managingOrganization
          Definition

          The organization that has assumed the specific responsibilities for the specified duration.

          ShortThis is the ACC Vendor ID, in most cases this is the organisation's HPI ID.Organization that assumes care
          Control10..1
          TypeReference(Organization)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. EpisodeOfCare.period
          Definition

          The interval during which the managing organization assumes the defined responsibility.

          ShortInterval during responsibility is assumed
          Control0..01
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. EpisodeOfCare.referralRequest
          Definition

          Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals.

          ShortOriginating Referral Request(s)
          Control0..0*
          TypeReference(ServiceRequest)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. EpisodeOfCare.careManager
          Definition

          The practitioner that is the care manager/care coordinator for this patient.

          ShortCare manager/care coordinator for the patient
          Control0..01
          TypeReference(Practitioner, PractitionerRole)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. EpisodeOfCare.team
          Definition

          The list of practitioners that may be facilitating this episode of care for specific purposes.

          ShortOther practitioners facilitating this episode of care
          Control0..0*
          TypeReference(CareTeam)
          Is Modifierfalse
          Summaryfalse
          Alternate NamesCareTeam
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. EpisodeOfCare.account
          Definition

          The set of accounts that may be used for billing for this EpisodeOfCare.

          ShortThe set of accounts that may be used for billing for this EpisodeOfCare
          Comments

          The billing system may choose to allocate billable items associated with the EpisodeOfCare to different referenced Accounts based on internal business rules.

          Control0..0*
          TypeReference(Account)
          Is Modifierfalse
          Summaryfalse
          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 found here

          0. EpisodeOfCare
          Definition

          An association between a patient and an organization / healthcare provider(s) during which time encounters may occur. The managing organization assumes a level of responsibility for the patient during this time.

          ShortAn association of a Patient with an Organization and Healthcare Provider(s) for a period of time that the Organization assumes some level of responsibility
          Control0..*
          Is Modifierfalse
          Summaryfalse
          Alternate NamesCase Program Problem
          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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: 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())
          end-date-when-active-invariant: End date is not allowed when status is active (status = 'active' implies period.end.empty())
          end-date-when-finished-invariant: End date is required when status is finished (status = 'finished' implies period.end.exists())
          active-status-invariant: The status attribute must be set to 'active'. (status = 'active')
          2. EpisodeOfCare.id
          Definition

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

          ShortLogical id of this artifact
          Comments

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

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. EpisodeOfCare.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
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. EpisodeOfCare.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 it's 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 it's meaning or interpretation
          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()))
          8. EpisodeOfCare.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 SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. EpisodeOfCare.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 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
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. EpisodeOfCare.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Control1..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          SlicingThis element introduces a set of slices on EpisodeOfCare.contained. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • profile @ $this
          • 14. EpisodeOfCare.contained:patient
            Slice Namepatient
            Definition

            Demographics and other administrative information about an individual or animal receiving care or other health-related services.

            ShortInformation about an individual or animal receiving health care services
            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.

            Control1..1
            TypePatient(ACC ICP Patient)
            Is Modifierfalse
            Summaryfalse
            Alternate NamesSubjectOfCare Client Resident
            16. EpisodeOfCare.extension
            Definition

            An Extension

            ShortExtension
            Control2..3
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            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 EpisodeOfCare.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 18. EpisodeOfCare.extension:acc-providerid
              Slice Nameacc-providerid
              Definition

              This represents the person submitting this form to ACC. It should take the form of their ACC Provider ID.

              ShortThe ACC provider ID associated with the ICP case
              Control1..1
              This element is affected by the following invariants: ele-1
              TypeExtension(ACC Provider ID) (Extension Type: string)
              Is Modifierfalse
              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())
              20. EpisodeOfCare.extension:service-bundle-change
              Slice Nameservice-bundle-change
              Definition

              An extension to capture the reason for a change in the ICP Service Bundle.

              ShortThe updated ICP service bundle for the treatment.
              Control1..1
              TypeExtension(ICP Service Bundle Change) (Complex Extension)
              Is Modifierfalse
              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())
              22. EpisodeOfCare.extension:exceptional-funding
              Slice Nameexceptional-funding
              Definition

              Indicates if exceptional is required for this treatment.

              ShortIndicates if exceptionalfunding is required for this treatment and the funding type.
              Control0..1
              TypeExtension(Exceptional Funding) (Complex Extension)
              Is Modifierfalse
              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())
              24. EpisodeOfCare.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 manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              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
              Summaryfalse
              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())
              26. EpisodeOfCare.identifier
              Definition

              The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

              ShortBusiness Identifier(s) relevant for this EpisodeOfCare
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control1..1
              TypeIdentifier
              Is Modifierfalse
              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 EpisodeOfCare.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ system
              • 28. EpisodeOfCare.identifier:icpclaimnumber
                Slice Nameicpclaimnumber
                Definition

                The EpisodeOfCare may be known by different identifiers for different contexts of use, such as when an external agency is tracking the Episode for funding purposes.

                ShortThe ACC 45 number to be used in combination with the contained patient's date of birth, as the ICP case idenfitier.
                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..1
                TypeIdentifier
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                30. EpisodeOfCare.identifier:icpclaimnumber.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..0
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                32. EpisodeOfCare.identifier:icpclaimnumber.extension
                Definition

                An Extension

                ShortExtension
                Control0..0
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                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 EpisodeOfCare.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 34. EpisodeOfCare.identifier:icpclaimnumber.use
                  Definition

                  The purpose of this identifier.

                  Shortusual | official | temp | secondary | old (If known)
                  Comments

                  Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                  Control0..1
                  BindingThe codes SHALL be taken from IdentifierUse
                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                  Identifies the purpose for this identifier, if known .

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  36. EpisodeOfCare.identifier:icpclaimnumber.type
                  Definition

                  A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                  ShortDescription of identifier
                  Comments

                  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.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                  (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                  A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows users to make use of identifiers when the identifier system is not known.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  38. EpisodeOfCare.identifier:icpclaimnumber.system
                  Definition

                  Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                  ShortThe namespace for the identifier value
                  Comments

                  Identifier.system is always case sensitive.

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

                  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.

                  Fixed Valuehttps://standards.digital.health.nz/ns/acc-45-number
                  Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  40. EpisodeOfCare.identifier:icpclaimnumber.value
                  Definition

                  The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                  ShortThe ACC 45 number.
                  Comments

                  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 Rendered Value extension. 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.

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Example<br/><b>General</b>:123456
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  acc-claim-number: The claim number format is invalid; it must be in the form A999999, AA99999, 9999AAA or 99999AA, where A is any capital letter, 9 is any single digit, and there are 7 characters altogether. ($this.toString().matches('^[A-Z][0-9]{6}$|^[A-Z]{2}[0-9]{5}$|^[0-9]{4}[A-Z]{3}$|^[0-9]{5}[A-Z]{2}$'))
                  42. EpisodeOfCare.identifier:icpclaimnumber.period
                  Definition

                  Time period during which identifier is/was valid for use.

                  ShortTime period when id is/was valid for use
                  Control0..0
                  TypePeriod
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  44. EpisodeOfCare.identifier:icpclaimnumber.assigner
                  Definition

                  Organization that issued/manages the identifier.

                  ShortOrganization that issued id (may be just text)
                  Comments

                  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.

                  Control0..0
                  TypeReference(Organization)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. EpisodeOfCare.status
                  Definition

                  The Status of the ICP case (must be Active).

                  Shortactive | finished
                  Comments

                  This element is labeled as a modifier because the status contains codes that mark the episode as not currently valid.

                  Control1..1
                  BindingThe codes SHALL be taken from Status
                  (required to http://hl7.org.nz/fhir/ValueSet/acc-icp-episodeofcare-status)
                  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
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. EpisodeOfCare.statusHistory
                  Definition

                  The history of statuses that the EpisodeOfCare has been through (without requiring processing the history of the resource).

                  ShortPast list of status codes (the current status may be included to cover the start date of the status)
                  Control0..0
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  55. EpisodeOfCare.type
                  Definition

                  A classification of the type of episode of care; e.g. specialist referral, disease management, type of funded care.

                  ShortThe type of ICP service. Currently only musculoskeletal (msk) is allowed, with more to be added in the future, e.g. concussion.
                  Comments

                  The type can be very important in processing as this could be used in determining if the EpisodeOfCare is relevant to specific government reporting, or other types of classifications.

                  Control0..0
                  BindingFor example codes, see EpisodeOfCareType
                  (example to http://hl7.org/fhir/ValueSet/episodeofcare-type)

                  The type of the episode of care.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  68. EpisodeOfCare.diagnosis
                  Definition

                  The list of diagnosis relevant to this episode of care.

                  ShortThe list of diagnosis relevant to this episode of care
                  Control0..0
                  TypeBackboneElement
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. EpisodeOfCare.patient
                  Definition

                  The patient who is the focus of this episode of care.

                  ShortThe patient who is the focus of this episode of care
                  Control1..1
                  TypeReference(ACC ICP Patient)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  78. EpisodeOfCare.managingOrganization
                  Definition

                  The organization that has assumed the specific responsibilities for the specified duration.

                  ShortThis is the ACC Vendor ID, in most cases this is the organisation's HPI ID.
                  Control1..1
                  TypeReference(Organization)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  80. EpisodeOfCare.period
                  Definition

                  The interval during which the managing organization assumes the defined responsibility.

                  ShortInterval during responsibility is assumed
                  Control0..0
                  TypePeriod
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  86. EpisodeOfCare.referralRequest
                  Definition

                  Referral Request(s) that are fulfilled by this EpisodeOfCare, incoming referrals.

                  ShortOriginating Referral Request(s)
                  Control0..0
                  TypeReference(ServiceRequest)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  88. EpisodeOfCare.careManager
                  Definition

                  The practitioner that is the care manager/care coordinator for this patient.

                  ShortCare manager/care coordinator for the patient
                  Control0..0
                  TypeReference(Practitioner, PractitionerRole)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  90. EpisodeOfCare.team
                  Definition

                  The list of practitioners that may be facilitating this episode of care for specific purposes.

                  ShortOther practitioners facilitating this episode of care
                  Control0..0
                  TypeReference(CareTeam)
                  Is Modifierfalse
                  Summaryfalse
                  Alternate NamesCareTeam
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  92. EpisodeOfCare.account
                  Definition

                  The set of accounts that may be used for billing for this EpisodeOfCare.

                  ShortThe set of accounts that may be used for billing for this EpisodeOfCare
                  Comments

                  The billing system may choose to allocate billable items associated with the EpisodeOfCare to different referenced Accounts based on internal business rules.

                  Control0..0
                  TypeReference(Account)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))