XpanDH Project
0.1.0 - ci-build 150

XpanDH Project, published by XpanDH Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/xpandh/ and changes regularly. See the Directory of published versions

## ValueSet: Confidentiality

Official URL: http://hl7.eu/fhir/ig/xpandh/ValueSet/eHDSIConfidentiality | Version: 0.1.0
Active as of 2025-10-10 | Computable Name: EHDSIConfidentiality

The Value Set is used for encoding the confidentiality level of the entire CDA. This Value Set encodes the level of access with regards to the content of the Value Set ? for example N concerns all the medical team, R is restricted for specialist that take care of the patient in certain circumstances, and VIP would be for the persons that need the Privacy Officer present or other special consideration (for example a celebrity hospitalized who needs their records protected)

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

### Logical Definition (CLD)

- Include these codes as defined in `http://terminology.hl7.org/CodeSystem/v3-Confidentiality` version 📦3.0.0

  Code | Display | Definition
  N | normal | Privacy metadata indicating the level of protection required to safeguard personal and healthcare information, which if disclosed without authorization, would present a considerable risk of harm to an individual's reputation and sense of privacy. *Usage Note:* The level of protection afforded normatively confidential information is dictated by the prevailing normative privacy policies, which are intended to engender patient trust in their healthcare providers. Privacy policies mandating normative levels of protection, which preempt less protective privacy policies when the information is used in the delivery and management of healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment). Confidentiality code total order hierarchy: Normal (N) is less protective than *V* and *R*, and subsumes all other protection levels (i.e., *M, L, and U*). **Map:**Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical Care when purpose of use is treatment: Default for normal clinical care access (i.e., most clinical staff directly caring for the patient should be able to access nearly all of the EHR). Maps to normal confidentiality for treatment information but not to ancillary care, payment and operations. **Examples:** n the US, this includes what HIPAA identifies as protected health information (PHI) under 45 CFR Section 160.103.
  R | restricted | Privacy metadata indicating the level of protection required to safeguard potentially stigmatizing information, which if disclosed without authorization, would present a high risk of harm to an individual's reputation and sense of privacy. *Usage Note:* The level of protection afforded restricted confidential information is dictated by specially protective organizational or jurisdictional privacy policies, including at an authorized individual's request, intended to engender patient trust in providers of sensitive services. Privacy policies mandating additional levels of protection by restricting information access preempt less protective privacy policies when the information is used in the delivery and management of healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment). Confidentiality code total order hierarchy: Restricted (R) is less protective than *V*, and subsumes all other protection levels (i.e., *N, M, L, and U*). **Examples:** Includes information that is additionally protected such as sensitive conditions mental health, HIV, substance abuse, domestic violence, child abuse, genetic disease, and reproductive health; or sensitive demographic information such as a patient's standing as an employee or a celebrity. May be used to indicate proprietary or classified information that is not related to an individual (e.g., secret ingredients in a therapeutic substance; or the name of a manufacturer).
  V | very restricted | Privacy metadata indicating the level of protection required under atypical cicumstances to safeguard potentially damaging or harmful information, which if disclosed without authorization, would (1) present an extremely high risk of harm to an individual's reputation, sense of privacy, and possibly safety; or (2) impact an individual's or organization's legal matters. *Usage Note:* The level of protection afforded very restricted confidential information is dictated by specially protective privacy or legal policies intended to ensure that under atypical circumstances additional protections limit access to only those with a high 'need to know' and the information is kept in highest confidence.. Privacy and legal policies mandating the highest level of protection by stringently restricting information access, preempt less protective privacy policies when the information is used in the delivery and management of healthcare including legal proceedings related to healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment but only under limited circumstances). Confidentiality code total order hierarchy: Very Restricted (V) is the highest protection level and subsumes all other protection levels s (i.e., *R, N, M, L, and UI*). **Examples:** Includes information about a victim of abuse, patient requested information sensitivity, and taboo subjects relating to health status that must be discussed with the patient by an attending provider before sharing with the patient. May also include information held under a legal hold or attorney-client privilege.

### Expansion

Expansion performed internally based on codesystem Confidentiality v3.0.0 (CodeSystem)

This value set contains 3 concepts

System | Code | Display (en) | JSON | XML
`http://terminology.hl7.org/CodeSystem/v3-Confidentiality` | N | normal |  |
`http://terminology.hl7.org/CodeSystem/v3-Confidentiality` | R | restricted |  |
`http://terminology.hl7.org/CodeSystem/v3-Confidentiality` | V | very restricted |  |

Explanation of the columns that may appear on this page:

Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System | The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code | The code (used as the code in the resource instance)
Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition | An explanation of the meaning of the concept
Comments | Additional notes about how to use the code