NZ Shared Digital Health Record API
1.1.6 - release

NZ Shared Digital Health Record API, published by Health New Zealand. This guide is not an authorized publication; it is the continuous build for version 1.1.6 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/tewhatuora/fhir-sdhr/ and changes regularly. See the Directory of published versions

Resource Profile: SDHRConsent - Detailed Descriptions

Active as of 2026-10-20

Definitions for the SDHRConsent resource profile.

See the documentation on how to interpret the contents of this table

0. Consent
Definition

A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.

ShortA healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
Comments

Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.

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())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
2. Consent.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. Consent.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())
6. Consent.status
Definition

Indicates the current state of this consent.

ShortThe state of the Consent. This must be active to release data from the serverdraft | proposed | active | rejected | inactive | entered-in-error
Comments

This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.

Control1..1
BindingThe codes SHALL be taken from ConsentStatehttp://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1
(required to http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1)

Indicates the state of the consent.

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
Requirements

The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.

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

A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible.

ShortWhich of the four areas this resource covers (extensible)
Control1..1
BindingUnless not suitable, these codes SHALL be taken from ConsentScopeCodeshttp://hl7.org/fhir/ValueSet/consent-scope|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/consent-scope|4.0.1)

The four anticipated uses for the Consent Resource.

TypeCodeableConcept
Is Modifiertrue because Allows changes to codes based on scope selection
Summarytrue
Pattern Value
{
  "coding" : [
    {
      "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
      "code" : "patient-privacy"
    }
  ]
}
<scope>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/consentscope"/>
    <code value="patient-privacy"/>
  </coding>
</scope>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Consent.category
Definition

The category of the consent, which is a code that indicates the type of consent


A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.

ShortThe category of the consent, which is a code that indicates the type of consentClassification of the consent statement - for indexing/retrieval
Control1..1*
BindingUnless not suitable, these codes SHALL be taken from ConsentCategoryCodeshttp://hl7.org/fhir/ValueSet/consent-category|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/consent-category|4.0.1)

A classification of the type of consents found in a consent statement.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Fixed Value
{
  "coding" : [
    {
      "system" : "http://snomed.info/sct",
      "code" : "887031000000108"
    }
  ]
}
<category>
  <coding>
    <system value="http://snomed.info/sct"/>
    <code value="887031000000108"/>
  </coding>
</category>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Consent.patient
Definition

The patient/healthcare consumer to whom this consent applies.

ShortWho the consent applies to
Comments

Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

Control10..1
TypeReference(Patient, Patient)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Consent.patient.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

ShortMust be an absolute URL reference to the patient on the NHI system. See constraints for details.Literal reference, Relative, internal or absolute URL
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control10..1
This element is affected by the following invariants: ref-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()))
nhi-url-format: Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA (matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$'))
16. Consent.patient.type
Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

ShortType the reference refers to (e.g. "Patient")
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Control10..1
BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types|4.0.1
(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Pattern Value
{
  "type" : "Patient"
}
<type value="Patient"/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Consent.policy
Definition

The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

ShortPolicies covered by this consent
Control10..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Consent.policy.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())
22. Consent.provision
Definition

An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.

ShortThe provision of the consent, which may be a permit or denyConstraints to the base Consent.policyRule
Control10..1
TypeBackboneElement
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
sdhr-unique-domain: Each domain may have only one recorded participation choice. (provision.where(class.where(system = 'https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains').exists()).class.code.isDistinct())
24. Consent.provision.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..*
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 Consent.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

    26. Consent.provision.extension:HNZGlobalOptOutReasonExtension
    Slice NameHNZGlobalOptOutReasonExtension
    Definition

    Records the reason for an HNZ global opt-off decision.

    ShortThe reason for the HNZ global opt-off
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(HNZ Global Opt Out Reason) (Extension Type: code)
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    28. Consent.provision.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())
    30. Consent.provision.type
    Definition

    Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

    ShortThe type of consent, either permit or denydeny | permit
    Control10..1
    BindingThe codes SHALL be taken from ConsentProvisionTypehttp://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1
    (required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1)

    How a rule statement is applied, such as adding additional consent or removing consent.

    Typecode
    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()))
    32. Consent.provision.action
    Definition

    Actions controlled by this Rule.

    ShortThe action that is being permitted or deniedActions controlled by this rule
    Comments

    Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.

    Control10..*
    BindingFor example codes, see ConsentActionCodeshttp://hl7.org/fhir/ValueSet/consent-action|4.0.1
    (example to http://hl7.org/fhir/ValueSet/consent-action|4.0.1)

    Detailed codes for the consent action.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Meaning if Missingall actions
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Consent.provision.provision
    Definition

    Rules which provide exceptions to the base rule or subrules.

    ShortNested Exception Rules
    Control0..*
    TypeBackboneElement
    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 Consent.provision.provision. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ class.system
    • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

      36. Consent.provision.provision.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..*
      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 Consent.provision.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

        38. Consent.provision.provision.extension:FacilityParticipationExtension
        Slice NameFacilityParticipationExtension
        Definition

        Indicates whether the patient has opted out or opted in to participation at the facility. If opted out, no records will be shared from that facility.

        ShortIndicates the patient has opted out of participation entirely at the facility
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Facility Participation) (Extension Type: CodeableConcept)
        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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        40. Consent.provision.provision.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())
        42. Consent.provision.provision:domainParticipation
        Slice NamedomainParticipation
        Definition

        Rules which provide exceptions to the base rule or subrules.

        ShortNested Exception Rules
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Consent.provision.provision:domainParticipation.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.

        Control10..*
        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 Consent.provision.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

          46. Consent.provision.provision:domainParticipation.extension:FacilityParticipationExtension
          Slice NameFacilityParticipationExtension
          Definition

          Indicates whether the patient has opted out or opted in to participation at the facility. If opted out, no records will be shared from that facility.

          ShortIndicates the patient has opted out of participation entirely at the facility
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Facility Participation) (Extension Type: CodeableConcept)
          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())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          48. Consent.provision.provision:domainParticipation.extension:lastUpdated
          Slice NamelastUpdated
          Definition

          When this recorded domain choice last changed. Metadata only; not an effective date.

          ShortDomain Participation Last Updated
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Domain Participation Last Updated) (Extension Type: instant)
          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())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          50. Consent.provision.provision:domainParticipation.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())
          52. Consent.provision.provision:domainParticipation.type
          Definition

          Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

          Shortdeny | permit
          Control10..1
          BindingThe codes SHALL be taken from ConsentProvisionTypehttp://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1
          (required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1)

          How a rule statement is applied, such as adding additional consent or removing consent.

          Typecode
          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()))
          54. Consent.provision.provision:domainParticipation.actor
          Definition

          Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

          ShortWho|what controlled by this rule (or group, by role)
          Control0..0*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Meaning if MissingThere is no specific actor associated with the exception
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          59. Consent.provision.provision:domainParticipation.class
          Definition

          The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.

          Shorte.g. Resource Type, Profile, CDA, etc.
          Comments

          Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.

          Control10..1*
          BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from SDHR Data Domainshttp://hl7.org/fhir/ValueSet/consent-content-class|4.0.1
          (required to https://fhir-ig.digital.health.nz/sdhr/ValueSet/sdhr-domains)
          TypeCoding
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          61. Consent.provision.provision:domainParticipation.class.system
          Definition

          The identification of the code system that defines the meaning of the symbol in the code.

          ShortIdentity of the terminology system
          Comments

          The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

          Need to be unambiguous about the source of the definition of the symbol.

          Pattern Value
          {
            "system" : "https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains"
          }
          <system value="https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains"/>
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          63. Consent.provision.provision:domainParticipation.data
          Definition

          The resources controlled by this rule if specific resources are referenced.

          ShortData controlled by this rule
          Control0..0*
          TypeBackboneElement
          Is Modifierfalse
          Summarytrue
          Meaning if Missingall data
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          See the documentation on how to interpret the contents of this table

          0. Consent
          2. Consent.status
          ShortThe state of the Consent. This must be active to release data from the server
          4. Consent.scope
          Pattern Value
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
                "code" : "patient-privacy"
              }
            ]
          }
          <scope>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/consentscope"/>
              <code value="patient-privacy"/>
            </coding>
          </scope>
          6. Consent.category
          Definition

          The category of the consent, which is a code that indicates the type of consent

          ShortThe category of the consent, which is a code that indicates the type of consent
          Control0..1
          Fixed Value
          {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "887031000000108"
              }
            ]
          }
          <category>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="887031000000108"/>
            </coding>
          </category>
          8. Consent.patient
          Control1..?
          TypeReference(Patient)
          10. Consent.patient.reference
          ShortMust be an absolute URL reference to the patient on the NHI system. See constraints for details.
          Control1..?
          Invariantsnhi-url-format: Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA (matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$'))
          12. Consent.patient.type
          Control1..?
          Pattern Value
          {
            "type" : "Patient"
          }
          <type value="Patient"/>
          14. Consent.policy
          Control1..?
          16. Consent.provision
          ShortThe provision of the consent, which may be a permit or deny
          Control1..?
          Invariantssdhr-unique-domain: Each domain may have only one recorded participation choice. (provision.where(class.where(system = 'https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains').exists()).class.code.isDistinct())
          18. Consent.provision.extension
          SlicingThis element introduces a set of slices on Consent.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

            20. Consent.provision.extension:HNZGlobalOptOutReasonExtension
            Slice NameHNZGlobalOptOutReasonExtension
            ShortThe reason for the HNZ global opt-off
            Control0..1
            TypeExtension(HNZ Global Opt Out Reason) (Extension Type: code)
            22. Consent.provision.type
            ShortThe type of consent, either permit or deny
            Control1..?
            24. Consent.provision.period
            26. Consent.provision.period.start
            ShortThe date and time the Consent is considered to be in effect
            Control1..?
            28. Consent.provision.period.end
            ShortThe date and time the Consent is considered to be expired
            30. Consent.provision.action
            ShortThe action that is being permitted or denied
            Control1..?
            32. Consent.provision.provision
            TypeBackboneElement
            SlicingThis element introduces a set of slices on Consent.provision.provision. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ class.system
            • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

              34. Consent.provision.provision.extension
              SlicingThis element introduces a set of slices on Consent.provision.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                36. Consent.provision.provision.extension:FacilityParticipationExtension
                Slice NameFacilityParticipationExtension
                ShortIndicates the patient has opted out of participation entirely at the facility
                Control0..1
                TypeExtension(Facility Participation) (Extension Type: CodeableConcept)
                38. Consent.provision.provision:domainParticipation
                Slice NamedomainParticipation
                Control0..*
                40. Consent.provision.provision:domainParticipation.extension
                Control1..?
                42. Consent.provision.provision:domainParticipation.extension:FacilityParticipationExtension
                Slice NameFacilityParticipationExtension
                ShortIndicates the patient has opted out of participation entirely at the facility
                Control0..1
                TypeExtension(Facility Participation) (Extension Type: CodeableConcept)
                44. Consent.provision.provision:domainParticipation.extension:lastUpdated
                Slice NamelastUpdated
                Control1..1
                TypeExtension(Domain Participation Last Updated) (Extension Type: instant)
                46. Consent.provision.provision:domainParticipation.type
                Control1..?
                48. Consent.provision.provision:domainParticipation.actor
                Control0..0
                50. Consent.provision.provision:domainParticipation.class
                Control1..1
                BindingThe codes SHALL be taken from SDHR Data Domains
                (required to https://fhir-ig.digital.health.nz/sdhr/ValueSet/sdhr-domains)
                52. Consent.provision.provision:domainParticipation.class.system
                Control1..?
                Pattern Value
                {
                  "system" : "https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains"
                }
                <system value="https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains"/>
                54. Consent.provision.provision:domainParticipation.data
                Control0..0

                See the documentation on how to interpret the contents of this table

                0. Consent
                Definition

                A record of a healthcare consumer’s choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.

                ShortA healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
                Comments

                Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.

                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())
                ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
                ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
                ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
                ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
                ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
                2. Consent.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. Consent.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. Consent.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. Consent.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|4.0.1)

                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. Consent.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. Consent.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. Consent.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. Consent.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. Consent.identifier
                Definition

                Unique identifier for this copy of the Consent Statement.

                ShortIdentifier for this record (external references)
                Comments

                This identifier identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..*
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                ExampleGeneral: { "system" : "http://acme.org/identifier/local/eCMS", "value" : "Local eCMS identifier" }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                20. Consent.status
                Definition

                Indicates the current state of this consent.

                ShortThe state of the Consent. This must be active to release data from the server
                Comments

                This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.

                Control1..1
                BindingThe codes SHALL be taken from ConsentState
                (required to http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1)

                Indicates the state of the consent.

                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
                Requirements

                The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.

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

                A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible.

                ShortWhich of the four areas this resource covers (extensible)
                Control1..1
                BindingUnless not suitable, these codes SHALL be taken from ConsentScopeCodes
                (extensible to http://hl7.org/fhir/ValueSet/consent-scope|4.0.1)

                The four anticipated uses for the Consent Resource.

                TypeCodeableConcept
                Is Modifiertrue because Allows changes to codes based on scope selection
                Summarytrue
                Pattern Value
                {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
                      "code" : "patient-privacy"
                    }
                  ]
                }
                <scope>
                  <coding>
                    <system value="http://terminology.hl7.org/CodeSystem/consentscope"/>
                    <code value="patient-privacy"/>
                  </coding>
                </scope>
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                24. Consent.category
                Definition

                The category of the consent, which is a code that indicates the type of consent

                ShortThe category of the consent, which is a code that indicates the type of consent
                Control1..1
                BindingUnless not suitable, these codes SHALL be taken from ConsentCategoryCodes
                (extensible to http://hl7.org/fhir/ValueSet/consent-category|4.0.1)

                A classification of the type of consents found in a consent statement.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Fixed Value
                {
                  "coding" : [
                    {
                      "system" : "http://snomed.info/sct",
                      "code" : "887031000000108"
                    }
                  ]
                }
                <category>
                  <coding>
                    <system value="http://snomed.info/sct"/>
                    <code value="887031000000108"/>
                  </coding>
                </category>
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                26. Consent.patient
                Definition

                The patient/healthcare consumer to whom this consent applies.

                ShortWho the consent applies to
                Comments

                Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

                Control1..1
                TypeReference(Patient)
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                28. Consent.patient.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
                30. Consent.patient.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())
                SlicingThis element introduces a set of slices on Consent.patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 32. Consent.patient.reference
                  Definition

                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                  ShortMust be an absolute URL reference to the patient on the NHI system. See constraints for details.
                  Comments

                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                  Control1..1
                  This element is affected by the following invariants: ref-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()))
                  nhi-url-format: Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA (matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$'))
                  34. Consent.patient.type
                  Definition

                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                  ShortType the reference refers to (e.g. "Patient")
                  Comments

                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                  (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

                  Aa resource (or, for logical models, the URI of the logical model).

                  Typeuri
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Pattern Value
                  {
                    "type" : "Patient"
                  }
                  <type value="Patient"/>
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  36. Consent.patient.identifier
                  Definition

                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                  ShortLogical reference, when literal reference is not known
                  Comments

                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1
                  TypeIdentifier
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  38. Consent.patient.display
                  Definition

                  Plain text narrative that identifies the resource in addition to the resource reference.

                  ShortText alternative for the resource
                  Comments

                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                  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()))
                  40. Consent.dateTime
                  Definition

                  When this Consent was issued / created / indexed.

                  ShortWhen this Consent was created or indexed
                  Comments

                  This is not the time of the original consent, but the time that this statement was made or derived.

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

                  Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions.

                  ShortWho is agreeing to the policy and rules
                  Comments

                  Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.

                  Control0..*
                  TypeReference(Organization, Patient, Practitioner, RelatedPerson, PractitionerRole)
                  Is Modifierfalse
                  Summarytrue
                  Alternate Namesconsentor
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  44. Consent.organization
                  Definition

                  The organization that manages the consent, and the framework within which it is executed.

                  ShortCustodian of the consent
                  Control0..*
                  TypeReference(Organization)
                  Is Modifierfalse
                  Summarytrue
                  Alternate Namescustodian
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. Consent.source[x]
                  Definition

                  The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document.

                  ShortSource from which this consent is taken
                  Comments

                  The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.

                  Control0..1
                  TypeChoice of: Attachment, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. Consent.policy
                  Definition

                  The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

                  ShortPolicies covered by this consent
                  Control1..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  50. Consent.policy.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
                  52. Consent.policy.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())
                  54. Consent.policy.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())
                  56. Consent.policy.authority
                  Definition

                  Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives.

                  ShortEnforcement source for policy
                  Control0..1
                  This element is affected by the following invariants: ppc-1
                  Typeuri
                  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()))
                  58. Consent.policy.uri
                  Definition

                  The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

                  ShortSpecific policy covered by this consent
                  Comments

                  This element is for discoverability / documentation and does not modify or qualify the policy rules.

                  Control0..1
                  This element is affected by the following invariants: ppc-1
                  Typeuri
                  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()))
                  60. Consent.policyRule
                  Definition

                  A reference to the specific base computable regulation or policy.

                  ShortRegulation that this consents to
                  Comments

                  If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource.

                  Control0..1
                  This element is affected by the following invariants: ppc-1
                  BindingUnless not suitable, these codes SHALL be taken from ConsentPolicyRuleCodes
                  (extensible to http://hl7.org/fhir/ValueSet/consent-policy|4.0.1)

                  Regulatory policy examples.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Might be a unique identifier of a policy set in XACML, or other rules engine.

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

                  Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person.

                  ShortConsent Verified by patient or family
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  64. Consent.verification.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
                  66. Consent.verification.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())
                  68. Consent.verification.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())
                  70. Consent.verification.verified
                  Definition

                  Has the instruction been verified.

                  ShortHas been verified
                  Control1..1
                  Typeboolean
                  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()))
                  72. Consent.verification.verifiedWith
                  Definition

                  Who verified the instruction (Patient, Relative or other Authorized Person).

                  ShortPerson who verified
                  Control0..1
                  TypeReference(Patient, RelatedPerson)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  74. Consent.verification.verificationDate
                  Definition

                  Date verification was collected.

                  ShortWhen consent verified
                  Control0..1
                  TypedateTime
                  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()))
                  76. Consent.provision
                  Definition

                  An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.

                  ShortThe provision of the consent, which may be a permit or deny
                  Control1..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  sdhr-unique-domain: Each domain may have only one recorded participation choice. (provision.where(class.where(system = 'https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains').exists()).class.code.isDistinct())
                  78. Consent.provision.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
                  80. Consent.provision.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..*
                  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 Consent.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                    82. Consent.provision.extension:HNZGlobalOptOutReasonExtension
                    Slice NameHNZGlobalOptOutReasonExtension
                    Definition

                    Records the reason for an HNZ global opt-off decision.

                    ShortThe reason for the HNZ global opt-off
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(HNZ Global Opt Out Reason) (Extension Type: code)
                    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())
                    84. Consent.provision.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())
                    86. Consent.provision.type
                    Definition

                    Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

                    ShortThe type of consent, either permit or deny
                    Control1..1
                    BindingThe codes SHALL be taken from ConsentProvisionType
                    (required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1)

                    How a rule statement is applied, such as adding additional consent or removing consent.

                    Typecode
                    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()))
                    88. Consent.provision.period
                    Definition

                    The timeframe in this rule is valid.

                    ShortTimeframe for this rule
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    90. Consent.provision.period.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
                    92. Consent.provision.period.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())
                    SlicingThis element introduces a set of slices on Consent.provision.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 94. Consent.provision.period.start
                      Definition

                      The start of the period. The boundary is inclusive.

                      ShortThe date and time the Consent is considered to be in effect
                      Comments

                      If the low element is missing, the meaning is that the low boundary is not known.

                      Control1..1
                      This element is affected by the following invariants: per-1
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      96. Consent.provision.period.end
                      Definition

                      The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

                      ShortThe date and time the Consent is considered to be expired
                      Comments

                      The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

                      Control0..1
                      This element is affected by the following invariants: per-1
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      98. Consent.provision.actor
                      Definition

                      Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

                      ShortWho|what controlled by this rule (or group, by role)
                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Summaryfalse
                      Meaning if MissingThere is no specific actor associated with the exception
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      100. Consent.provision.actor.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
                      102. Consent.provision.actor.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())
                      104. Consent.provision.actor.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())
                      106. Consent.provision.actor.role
                      Definition

                      How the individual is involved in the resources content that is described in the exception.

                      ShortHow the actor is involved
                      Control1..1
                      BindingUnless not suitable, these codes SHALL be taken from SecurityRoleType
                      (extensible to http://hl7.org/fhir/ValueSet/security-role-type|4.0.1)

                      How an actor is involved in the consent considerations.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      108. Consent.provision.actor.reference
                      Definition

                      The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').

                      ShortResource for the actor (or group, by role)
                      Control1..1
                      TypeReference(Device, Group, CareTeam, Organization, Patient, Practitioner, RelatedPerson, PractitionerRole)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      110. Consent.provision.action
                      Definition

                      Actions controlled by this Rule.

                      ShortThe action that is being permitted or denied
                      Comments

                      Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.

                      Control1..*
                      BindingFor example codes, see ConsentActionCodes
                      (example to http://hl7.org/fhir/ValueSet/consent-action|4.0.1)

                      Detailed codes for the consent action.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Meaning if Missingall actions
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      112. Consent.provision.securityLabel
                      Definition

                      A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.

                      ShortSecurity Labels that define affected resources
                      Comments

                      If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

                      Control0..*
                      BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                      (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

                      Security Labels from the Healthcare Privacy and Security Classification System.

                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      114. Consent.provision.purpose
                      Definition

                      The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule.

                      ShortContext of activities covered by this rule
                      Comments

                      When the purpose of use tag is on the data, access request purpose of use shall not conflict.

                      Control0..*
                      BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
                      (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

                      What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.

                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      116. Consent.provision.class
                      Definition

                      The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.

                      Shorte.g. Resource Type, Profile, CDA, etc.
                      Comments

                      Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.

                      Control0..*
                      BindingUnless not suitable, these codes SHALL be taken from ConsentContentClass
                      (extensible to http://hl7.org/fhir/ValueSet/consent-content-class|4.0.1)

                      The class (type) of information a consent rule covers.

                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      118. Consent.provision.code
                      Definition

                      If this code is found in an instance, then the rule applies.

                      Shorte.g. LOINC or SNOMED CT code, etc. in the content
                      Comments

                      Typical use of this is a Document code with class = CDA.

                      Control0..*
                      BindingFor example codes, see ConsentContentCodes
                      (example to http://hl7.org/fhir/ValueSet/consent-content-code|4.0.1)

                      If this code is found in an instance, then the exception applies.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      120. Consent.provision.dataPeriod
                      Definition

                      Clinical or Operational Relevant period of time that bounds the data controlled by this rule.

                      ShortTimeframe for data controlled by this rule
                      Comments

                      This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

                      Control0..1
                      TypePeriod
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      122. Consent.provision.data
                      Definition

                      The resources controlled by this rule if specific resources are referenced.

                      ShortData controlled by this rule
                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Summarytrue
                      Meaning if Missingall data
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      124. Consent.provision.data.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
                      126. Consent.provision.data.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())
                      128. Consent.provision.data.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())
                      130. Consent.provision.data.meaning
                      Definition

                      How the resource reference is interpreted when testing consent restrictions.

                      Shortinstance | related | dependents | authoredby
                      Control1..1
                      BindingThe codes SHALL be taken from ConsentDataMeaning
                      (required to http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1)

                      How a resource reference is interpreted when testing consent restrictions.

                      Typecode
                      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()))
                      132. Consent.provision.data.reference
                      Definition

                      A reference to a specific resource that defines which resources are covered by this consent.

                      ShortThe actual data reference
                      Control1..1
                      TypeReference(Resource)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      134. Consent.provision.provision
                      Definition

                      Rules which provide exceptions to the base rule or subrules.

                      ShortNested Exception Rules
                      Control0..*
                      TypeBackboneElement
                      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 Consent.provision.provision. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ class.system
                      • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                        136. Consent.provision.provision.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
                        138. Consent.provision.provision.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control0..*
                        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 Consent.provision.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                          140. Consent.provision.provision.extension:FacilityParticipationExtension
                          Slice NameFacilityParticipationExtension
                          Definition

                          Indicates whether the patient has opted out or opted in to participation at the facility. If opted out, no records will be shared from that facility.

                          ShortIndicates the patient has opted out of participation entirely at the facility
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(Facility Participation) (Extension Type: CodeableConcept)
                          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())
                          142. Consent.provision.provision.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())
                          144. Consent.provision.provision.type
                          Definition

                          Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

                          Shortdeny | permit
                          Control0..1
                          BindingThe codes SHALL be taken from ConsentProvisionType
                          (required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1)

                          How a rule statement is applied, such as adding additional consent or removing consent.

                          Typecode
                          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()))
                          146. Consent.provision.provision.period
                          Definition

                          The timeframe in this rule is valid.

                          ShortTimeframe for this rule
                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          148. Consent.provision.provision.actor
                          Definition

                          Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

                          ShortWho|what controlled by this rule (or group, by role)
                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Meaning if MissingThere is no specific actor associated with the exception
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          150. Consent.provision.provision.actor.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
                          152. Consent.provision.provision.actor.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())
                          154. Consent.provision.provision.actor.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())
                          156. Consent.provision.provision.actor.role
                          Definition

                          How the individual is involved in the resources content that is described in the exception.

                          ShortHow the actor is involved
                          Control1..1
                          BindingUnless not suitable, these codes SHALL be taken from SecurityRoleType
                          (extensible to http://hl7.org/fhir/ValueSet/security-role-type|4.0.1)

                          How an actor is involved in the consent considerations.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          158. Consent.provision.provision.actor.reference
                          Definition

                          The resource that identifies the actor. To identify actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').

                          ShortResource for the actor (or group, by role)
                          Control1..1
                          TypeReference(Device, Group, CareTeam, Organization, Patient, Practitioner, RelatedPerson, PractitionerRole)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          160. Consent.provision.provision.action
                          Definition

                          Actions controlled by this Rule.

                          ShortActions controlled by this rule
                          Comments

                          Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.

                          Control0..*
                          BindingFor example codes, see ConsentActionCodes
                          (example to http://hl7.org/fhir/ValueSet/consent-action|4.0.1)

                          Detailed codes for the consent action.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Meaning if Missingall actions
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          162. Consent.provision.provision.securityLabel
                          Definition

                          A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.

                          ShortSecurity Labels that define affected resources
                          Comments

                          If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

                          Control0..*
                          BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                          (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

                          Security Labels from the Healthcare Privacy and Security Classification System.

                          TypeCoding
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          164. Consent.provision.provision.purpose
                          Definition

                          The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule.

                          ShortContext of activities covered by this rule
                          Comments

                          When the purpose of use tag is on the data, access request purpose of use shall not conflict.

                          Control0..*
                          BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
                          (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

                          What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.

                          TypeCoding
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          166. Consent.provision.provision.class
                          Definition

                          The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.

                          Shorte.g. Resource Type, Profile, CDA, etc.
                          Comments

                          Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.

                          Control0..*
                          BindingUnless not suitable, these codes SHALL be taken from ConsentContentClass
                          (extensible to http://hl7.org/fhir/ValueSet/consent-content-class|4.0.1)

                          The class (type) of information a consent rule covers.

                          TypeCoding
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          168. Consent.provision.provision.code
                          Definition

                          If this code is found in an instance, then the rule applies.

                          Shorte.g. LOINC or SNOMED CT code, etc. in the content
                          Comments

                          Typical use of this is a Document code with class = CDA.

                          Control0..*
                          BindingFor example codes, see ConsentContentCodes
                          (example to http://hl7.org/fhir/ValueSet/consent-content-code|4.0.1)

                          If this code is found in an instance, then the exception applies.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          170. Consent.provision.provision.dataPeriod
                          Definition

                          Clinical or Operational Relevant period of time that bounds the data controlled by this rule.

                          ShortTimeframe for data controlled by this rule
                          Comments

                          This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          172. Consent.provision.provision.data
                          Definition

                          The resources controlled by this rule if specific resources are referenced.

                          ShortData controlled by this rule
                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summarytrue
                          Meaning if Missingall data
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          174. Consent.provision.provision.data.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
                          176. Consent.provision.provision.data.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())
                          178. Consent.provision.provision.data.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())
                          180. Consent.provision.provision.data.meaning
                          Definition

                          How the resource reference is interpreted when testing consent restrictions.

                          Shortinstance | related | dependents | authoredby
                          Control1..1
                          BindingThe codes SHALL be taken from ConsentDataMeaning
                          (required to http://hl7.org/fhir/ValueSet/consent-data-meaning|4.0.1)

                          How a resource reference is interpreted when testing consent restrictions.

                          Typecode
                          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()))
                          182. Consent.provision.provision.data.reference
                          Definition

                          A reference to a specific resource that defines which resources are covered by this consent.

                          ShortThe actual data reference
                          Control1..1
                          TypeReference(Resource)
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          184. Consent.provision.provision.provision
                          Definition

                          Rules which provide exceptions to the base rule or subrules.

                          ShortNested Exception Rules
                          Control0..*
                          TypeSeettp://hl7.org/fhir/StructureDefinition/Consent#Consent.provision
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          186. Consent.provision.provision:domainParticipation
                          Slice NamedomainParticipation
                          Definition

                          Rules which provide exceptions to the base rule or subrules.

                          ShortNested Exception Rules
                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          188. Consent.provision.provision:domainParticipation.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
                          190. Consent.provision.provision:domainParticipation.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control1..*
                          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 Consent.provision.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

                            192. Consent.provision.provision:domainParticipation.extension:FacilityParticipationExtension
                            Slice NameFacilityParticipationExtension
                            Definition

                            Indicates whether the patient has opted out or opted in to participation at the facility. If opted out, no records will be shared from that facility.

                            ShortIndicates the patient has opted out of participation entirely at the facility
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Facility Participation) (Extension Type: CodeableConcept)
                            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())
                            194. Consent.provision.provision:domainParticipation.extension:lastUpdated
                            Slice NamelastUpdated
                            Definition

                            When this recorded domain choice last changed. Metadata only; not an effective date.

                            ShortDomain Participation Last Updated
                            Control1..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Domain Participation Last Updated) (Extension Type: instant)
                            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())
                            196. Consent.provision.provision:domainParticipation.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())
                            198. Consent.provision.provision:domainParticipation.type
                            Definition

                            Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

                            Shortdeny | permit
                            Control1..1
                            BindingThe codes SHALL be taken from ConsentProvisionType
                            (required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1)

                            How a rule statement is applied, such as adding additional consent or removing consent.

                            Typecode
                            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()))
                            200. Consent.provision.provision:domainParticipation.period
                            Definition

                            The timeframe in this rule is valid.

                            ShortTimeframe for this rule
                            Control0..1
                            TypePeriod
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            202. Consent.provision.provision:domainParticipation.actor
                            Definition

                            Who or what is controlled by this rule. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

                            ShortWho|what controlled by this rule (or group, by role)
                            Control0..0
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            Meaning if MissingThere is no specific actor associated with the exception
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            209. Consent.provision.provision:domainParticipation.action
                            Definition

                            Actions controlled by this Rule.

                            ShortActions controlled by this rule
                            Comments

                            Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.

                            Control0..*
                            BindingFor example codes, see ConsentActionCodes
                            (example to http://hl7.org/fhir/ValueSet/consent-action|4.0.1)

                            Detailed codes for the consent action.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Meaning if Missingall actions
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            211. Consent.provision.provision:domainParticipation.securityLabel
                            Definition

                            A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.

                            ShortSecurity Labels that define affected resources
                            Comments

                            If the consent specifies a security label of "R" then it applies to all resources that are labeled "R" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

                            Control0..*
                            BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                            (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

                            Security Labels from the Healthcare Privacy and Security Classification System.

                            TypeCoding
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            213. Consent.provision.provision:domainParticipation.purpose
                            Definition

                            The context of the activities a user is taking - why the user is accessing the data - that are controlled by this rule.

                            ShortContext of activities covered by this rule
                            Comments

                            When the purpose of use tag is on the data, access request purpose of use shall not conflict.

                            Control0..*
                            BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
                            (extensible to http://terminology.hl7.org/ValueSet/v3-PurposeOfUse)

                            What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels.

                            TypeCoding
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            215. Consent.provision.provision:domainParticipation.class
                            Definition

                            The class of information covered by this rule. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.

                            Shorte.g. Resource Type, Profile, CDA, etc.
                            Comments

                            Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.

                            Control1..1
                            BindingThe codes SHALL be taken from SDHR Data Domains
                            (required to https://fhir-ig.digital.health.nz/sdhr/ValueSet/sdhr-domains)
                            TypeCoding
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            217. Consent.provision.provision:domainParticipation.class.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
                            219. Consent.provision.provision:domainParticipation.class.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())
                            SlicingThis element introduces a set of slices on Consent.provision.provision.class.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 221. Consent.provision.provision:domainParticipation.class.system
                              Definition

                              The identification of the code system that defines the meaning of the symbol in the code.

                              ShortIdentity of the terminology system
                              Comments

                              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                              Need to be unambiguous about the source of the definition of the symbol.

                              Pattern Value
                              {
                                "system" : "https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains"
                              }
                              <system value="https://fhir-ig.digital.health.nz/sdhr/CodeSystem/sdhr-domains"/>
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              223. Consent.provision.provision:domainParticipation.class.version
                              Definition

                              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                              ShortVersion of the system - if relevant
                              Comments

                              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                              NoteThis is a business version Id, not a resource version Id (see discussion)
                              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()))
                              225. Consent.provision.provision:domainParticipation.class.code
                              Definition

                              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                              ShortSymbol in syntax defined by the system
                              Control0..1
                              Typecode
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              Need to refer to a particular code in the system.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              227. Consent.provision.provision:domainParticipation.class.display
                              Definition

                              A representation of the meaning of the code in the system, following the rules of the system.

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

                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              229. Consent.provision.provision:domainParticipation.class.userSelected
                              Definition

                              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                              ShortIf this coding was chosen directly by the user
                              Comments

                              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              231. Consent.provision.provision:domainParticipation.code
                              Definition

                              If this code is found in an instance, then the rule applies.

                              Shorte.g. LOINC or SNOMED CT code, etc. in the content
                              Comments

                              Typical use of this is a Document code with class = CDA.

                              Control0..*
                              BindingFor example codes, see ConsentContentCodes
                              (example to http://hl7.org/fhir/ValueSet/consent-content-code|4.0.1)

                              If this code is found in an instance, then the exception applies.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              233. Consent.provision.provision:domainParticipation.dataPeriod
                              Definition

                              Clinical or Operational Relevant period of time that bounds the data controlled by this rule.

                              ShortTimeframe for data controlled by this rule
                              Comments

                              This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.

                              Control0..1
                              TypePeriod
                              Is Modifierfalse
                              Summarytrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              235. Consent.provision.provision:domainParticipation.data
                              Definition

                              The resources controlled by this rule if specific resources are referenced.

                              ShortData controlled by this rule
                              Control0..0
                              TypeBackboneElement
                              Is Modifierfalse
                              Summarytrue
                              Meaning if Missingall data
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              242. Consent.provision.provision:domainParticipation.provision
                              Definition

                              Rules which provide exceptions to the base rule or subrules.

                              ShortNested Exception Rules
                              Control0..*
                              TypeSeettp://hl7.org/fhir/StructureDefinition/Consent#Consent.provision
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))