New Zealand Rheumatic Fever FHIR Implementation Guide
1.0.0 - draft

New Zealand Rheumatic Fever FHIR Implementation Guide, published by Te Whatu Ora. 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/tewhatuora/fhir-rheumatic-fever/ and changes regularly. See the Directory of published versions

Resource Profile: RheumaticFeverCareTeam - Detailed Descriptions

Draft as of 2024-09-26

Definitions for the nz-rheumaticfever-careteam resource profile.

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

0. CareTeam
InvariantsCareTeamRFNZCategoryConstraint: All RF CareTeam instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG) (CareTeam.category.where(coding.code='rf-nz').exists())
2. CareTeam.meta
InvariantsRFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG) (tag.code contains 'rf-nz')
4. CareTeam.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
SlicingThis element introduces a set of slices on CareTeam.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ use
  • 6. CareTeam.identifier:NationalSystem
    Slice NameNationalSystem
    ShortThis allows a rheumatic fever patient resource to link with corresponding objects in systems like RFCCS
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    8. CareTeam.identifier:NationalSystem.id
    Control0..0
    10. CareTeam.identifier:NationalSystem.extension
    Control0..0
    12. CareTeam.identifier:NationalSystem.use
    Control1..?
    Pattern Valueusual
    14. CareTeam.identifier:NationalSystem.type
    Control1..?
    BindingThe codes SHALL be taken from External identifier type codes
    (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code)
    16. CareTeam.identifier:NationalSystem.system
    Example<br/><b>uri</b>:https://standards.digital.health.nz/ns/rfccs
    18. CareTeam.identifier:NationalSystem.value
    Control1..?
    Example<br/><b>RFCCS object id</b>:CTM-0000144
    20. CareTeam.category
    Control1..?

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

    0. CareTeam
    Definition

    The Care Team includes all the people and organizations who plan to participate in the coordination and delivery of care for a patient.

    ShortPlanned participants in the coordination and delivery of care for a patient or group
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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())
    CareTeamRFNZCategoryConstraint: All RF CareTeam instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG) (CareTeam.category.where(coding.code='rf-nz').exists())
    2. CareTeam.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()))
    RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG) (tag.code contains 'rf-nz')
    4. CareTeam.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()))
    6. CareTeam.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())
    8. CareTeam.identifier
    Definition

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

    ShortExternal Ids for this team
    Comments

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

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

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on CareTeam.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ use
    • 10. CareTeam.identifier:NationalSystem
      Slice NameNationalSystem
      Definition

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

      ShortThis allows a rheumatic fever patient resource to link with corresponding objects in systems like RFCCSExternal Ids for this team
      Comments

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

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

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. CareTeam.identifier:NationalSystem.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
      14. CareTeam.identifier:NationalSystem.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 CareTeam.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. CareTeam.identifier:NationalSystem.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.

        Control10..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.

        Pattern Valueusual
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. CareTeam.identifier:NationalSystem.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.

        Control10..1
        BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from External identifier type codeshttp://hl7.org/fhir/ValueSet/identifier-type
        (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code)
        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()))
        20. CareTeam.identifier:NationalSystem.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.

        Control0..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.

        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient <br/><b>uri</b>:https://standards.digital.health.nz/ns/rfccs
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. CareTeam.identifier:NationalSystem.value
        Definition

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

        ShortThe 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 <br/><b>RFCCS object id</b>:CTM-0000144
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. CareTeam.status
        Definition

        Indicates the current state of the care team.

        Shortproposed | active | suspended | inactive | entered-in-error
        Comments

        This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.

        Control0..1
        BindingThe codes SHALL be taken from CareTeamStatushttp://hl7.org/fhir/ValueSet/care-team-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/care-team-status|4.0.1)

        Indicates the status of the care team.

        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()))
        26. CareTeam.category
        Definition

        Identifies what kind of team. This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.

        ShortType of team
        Comments

        There may be multiple axis of categorization and one team may serve multiple purposes.

        Control10..*
        BindingFor example codes, see CareTeamCategoryhttp://hl7.org/fhir/ValueSet/care-team-category
        (example to http://hl7.org/fhir/ValueSet/care-team-category)

        Indicates the type of care team.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        Used for filtering what teams(s) are retrieved and displayed to different types of users.

        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. CareTeam
        Definition

        The Care Team includes all the people and organizations who plan to participate in the coordination and delivery of care for a patient.

        ShortPlanned participants in the coordination and delivery of care for a patient or group
        Control0..*
        Is Modifierfalse
        Summaryfalse
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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())
        CareTeamRFNZCategoryConstraint: All RF CareTeam instances shall have a category #rf-nz (NZ rheumatic fever code defined in this IG) (CareTeam.category.where(coding.code='rf-nz').exists())
        2. CareTeam.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. CareTeam.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()))
        RFNZTagConstraint: All instances shall have an #rf-nz meta.tag (the NZ rheumatic fever generic code defined in this IG) (tag.code contains 'rf-nz')
        6. CareTeam.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. CareTeam.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. CareTeam.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. CareTeam.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.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        14. CareTeam.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and 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.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. CareTeam.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. CareTeam.identifier
        Definition

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

        ShortExternal Ids for this team
        Comments

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

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

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on CareTeam.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ use
        • 20. CareTeam.identifier:NationalSystem
          Slice NameNationalSystem
          Definition

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

          ShortThis allows a rheumatic fever patient resource to link with corresponding objects in systems like RFCCS
          Comments

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

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

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. CareTeam.identifier:NationalSystem.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
          24. CareTeam.identifier:NationalSystem.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 CareTeam.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 26. CareTeam.identifier:NationalSystem.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.

            Control1..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.

            Pattern Valueusual
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. CareTeam.identifier:NationalSystem.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.

            Control1..1
            BindingThe codes SHALL be taken from External identifier type codes
            (required to https://fhir-ig.digital.health.nz/rheumatic-fever/ValueSet/external-system-identifier-type-code)
            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()))
            30. CareTeam.identifier:NationalSystem.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.

            Control0..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.

            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient <br/><b>uri</b>:https://standards.digital.health.nz/ns/rfccs
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. CareTeam.identifier:NationalSystem.value
            Definition

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

            ShortThe 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.

            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 <br/><b>RFCCS object id</b>:CTM-0000144
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. CareTeam.identifier:NationalSystem.period
            Definition

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

            ShortTime period when id is/was valid for use
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. CareTeam.identifier:NationalSystem.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..1
            TypeReference(Organization)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. CareTeam.status
            Definition

            Indicates the current state of the care team.

            Shortproposed | active | suspended | inactive | entered-in-error
            Comments

            This element is labeled as a modifier because the status contains the code entered-in-error that marks the care team as not currently valid.

            Control0..1
            BindingThe codes SHALL be taken from CareTeamStatus
            (required to http://hl7.org/fhir/ValueSet/care-team-status|4.0.1)

            Indicates the status of the care team.

            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()))
            40. CareTeam.category
            Definition

            Identifies what kind of team. This is to support differentiation between multiple co-existing teams, such as care plan team, episode of care team, longitudinal care team.

            ShortType of team
            Comments

            There may be multiple axis of categorization and one team may serve multiple purposes.

            Control1..*
            BindingFor example codes, see CareTeamCategory
            (example to http://hl7.org/fhir/ValueSet/care-team-category)

            Indicates the type of care team.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Used for filtering what teams(s) are retrieved and displayed to different types of users.

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

            A label for human use intended to distinguish like teams. E.g. the "red" vs. "green" trauma teams.

            ShortName of the team, such as crisis assessment team
            Comments

            The meaning/purpose of the team is conveyed in CareTeam.category. This element may also convey semantics of the team (e.g. "Red trauma team"), but its primary purpose is to distinguish between identical teams in a human-friendly way. ("Team 18735" isn't as friendly.).

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. CareTeam.subject
            Definition

            Identifies the patient or group whose intended care is handled by the team.

            ShortWho care team is for
            Control0..1
            TypeReference(Patient, Group)
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows the team to care for a group (e.g. marriage) therapy. Allows for an organization to designate a team such as the PICC line team.

            Alternate Namespatient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            46. CareTeam.encounter
            Definition

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

            ShortEncounter created as part of
            Comments

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

            Control0..1
            TypeReference(Encounter)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            48. CareTeam.period
            Definition

            Indicates when the team did (or is intended to) come into effect and end.

            ShortTime period team covers
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows tracking what team(s) are in effect at a particular time.

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

            Identifies all people and organizations who are expected to be involved in the care team.

            ShortMembers of the team
            Control0..*
            This element is affected by the following invariants: ctm-1
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantsctm-1: CareTeam.participant.onBehalfOf can only be populated when CareTeam.participant.member is a Practitioner (onBehalfOf.exists() implies (member.resolve().iif(empty(), true, ofType(Practitioner).exists())))
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. CareTeam.participant.id
            Definition

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

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            54. CareTeam.participant.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and 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.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            56. CareTeam.participant.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            Indicates specific responsibility of an individual within the care team, such as "Primary care physician", "Trained social worker counselor", "Caregiver", etc.

            ShortType of involvement
            Comments

            Roles may sometimes be inferred by type of Practitioner. These are relationships that hold only within the context of the care team. General relationships should be handled as properties of the Patient resource directly.

            Control0..*
            BindingFor example codes, see ParticipantRoles
            (example to http://hl7.org/fhir/ValueSet/participant-role)

            Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. CareTeam.participant.member
            Definition

            The specific person or organization who is participating/expected to participate in the care team.

            ShortWho is involved
            Comments

            Patient only needs to be listed if they have a role other than "subject of care".

            Member is optional because some participants may be known only by their role, particularly in draft plans.

            Control0..1
            TypeReference(Practitioner, PractitionerRole, RelatedPerson, Patient, Organization, CareTeam)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. CareTeam.participant.onBehalfOf
            Definition

            The organization of the practitioner.

            ShortOrganization of the practitioner
            Control0..1
            TypeReference(Organization)
            Is Modifierfalse
            Summarytrue
            Requirements

            Practitioners can be associated with multiple organizations. This element indicates which organization they were acting on behalf of.

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

            Indicates when the specific member or organization did (or is intended to) come into effect and end.

            ShortTime period of participant
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. CareTeam.reasonCode
            Definition

            Describes why the care team exists.

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

            Indicates the reason for the care team.

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

            Condition(s) that this care team addresses.

            ShortWhy the care team exists
            Control0..*
            TypeReference(Condition)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. CareTeam.managingOrganization
            Definition

            The organization responsible for the care team.

            ShortOrganization responsible for the care team
            Control0..*
            TypeReference(Organization)
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows for multiple organizations to collaboratively manage cross-organizational, longitudinal care plan.

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

            A central contact detail for the care team (that applies to all members).

            ShortA contact detail for the care team (that applies to all members)
            Comments

            The ContactPoint.use code of home is not appropriate to use. These contacts are not the contact details of individual care team members.

            Control0..*
            TypeContactPoint
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. CareTeam.note
            Definition

            Comments made about the CareTeam.

            ShortComments made about the CareTeam
            Control0..*
            TypeAnnotation
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))