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8.5 Resource PractitionerRole - Content

Patient Administration icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Individual Compartments: Practitioner

A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time.

The PractitionerRole describes the types of services that practitioners provide for an organization at specific location(s).

The PractitionerRole resource can be used in multiple contexts including:

  • Provider Registries where it indicates what a practitioner can perform for an organization (may indicate multiple healthcareservices, locations, and roles)
  • In a Clinical system where it indicates the role, healthcareservice and location details associated with a practitioner that are applicable to the healthcare event (e.g. Observation, Appointment, Condition, CarePlan)
  • In a Clinical system as a point of reference rather than an event, such as a patient's preferred general practitioner (at a specific clinic)

The role, specialty, Location telecom and HealthcareService properties can be repeated if required in other instances of the PractitionerRole. Some systems record a collection of service values for a single location, others record the single service and the list of locations it is available. Both are acceptable options for representing this data.
Where availability, telecom, or other details are not the same across all healthcareservices, or locations a separate PractitionerRole instance should be created.

Many resource types have a choice of a reference to either a Practitioner resource or a PractitionerRole resource. The latter provides organizational context for the practitioners participation when it is required, otherwise a direct reference to the practitioner may be used.
Many implementations may choose to profile the PractitionerRole to a single location/role/healthcareservice for their specific usage.
As the property that references a PractitionerRole typically has a specific context, the code on the PractitionerRole having duplicate code values is not a big concern (and is used for discovery where required).
e.g. These references are all very context specific: Patient.GeneralPractitioner, CarePlan.reported, CarePlan.contributor, Appointment.participant (through the participant.role), Immunization.informationSource, Immunization.performer (through the performer.function property)

For use cases where an organization has activities where a practitioner is not defined/pre-allocated for a specific role (e.g. an un-named surgeon at XYZ Hospital), a PractitionerRole resource can be used with an empty Practitioner property, and the other relevant role properties populated - i.e. code, organization.

Qualifications (from the Practitioner resource) do not imply a Role, but might be considered when an Organization allocates practitioners to roles within their organization, and could provide useful information (such as expiry information) which could need to be tracked in some situations to ensure they continue to be eligible for a specific role.

The CareTeam resource is also often used to provide details of a role that a practitioner is allocated to perform, but is usually scoped to a much finer granularity of care, and often within the specific context of a Patient, or functional role (e.g. Crisis planning team). In contrast the PractitionerRole is used in a more general sense to cover all the places that the practitioner is allocated to work (and specific details relevant to that role - such as a specific contact number, or electronic services endpoint).

When referencing a practitioner from clinical (or other) content where the organization and role are important to the context of the reference to the practitioner, then a reference to the PractitionerRole should be used.

Practitioner performs different roles within the same or even different organizations. Depending on jurisdiction and custom, it may be necessary to maintain a specific Practitioner Resource for each such role or have a single Practitioner with multiple roles. The role can be limited to a specific period, after which authorization for this role ends. Note that the represented organization need not necessarily be the (direct) employer of a Practitioner.

Structure

Name iconFlags iconCard. iconType iconDescription & Constraints icondoco icon
.. PractitionerRole TUDomainResourceRoles/organizations the practitioner is associated with

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness Identifiers that are specific to a role/location

... active Σ0..1booleanWhether this practitioner role record is in active use
... period Σ0..1PeriodThe period during which the practitioner is authorized to perform in these role(s)
... organization Σ0..1Reference(Organization)Organization where the roles are available
... code Σ0..*CodeableConceptRoles which this practitioner may perform
PractitionerRole (Example)

... specialty Σ0..*CodeableConceptSpecific specialty of the practitioner
Practice Setting Code Value Set (Preferred)

... location Σ0..*Reference(Location)The location(s) at which this practitioner provides care

... healthcareService 0..*Reference(HealthcareService)The list of healthcare services that this worker provides for this role's Organization/Location(s)

... contact 0..*ExtendedContactDetailOfficial contact details relating to this PractitionerRole

... availability 0..*AvailabilityTimes the Practitioner is available at this location and/or healthcare service (including exceptions)

... endpoint 0..*Reference(Endpoint)Technical endpoints providing access to services operated for the practitioner with this role


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

PractitionerRole (DomainResource)Business Identifiers that are specific to a role/locationidentifier : Identifier [0..*]Whether this practitioner role record is in active useactive : boolean [0..1]The period during which the person is authorized to act as a practitioner in these role(s) for the organizationperiod : Period [0..1]Practitioner that is able to provide the defined services for the organizationpractitioner : Reference [0..1] « Practitioner »The organization where the Practitioner performs the roles associatedorganization : Reference [0..1] « Organization »Roles which this practitioner is authorized to perform for the organizationcode : CodeableConcept [0..*] « null (Strength=Example)PractitionerRole?? »The specialty of a practitioner that describes the functional role they are practicing at a given organization or locationspecialty : CodeableConcept [0..*] « null (Strength=Preferred)PracticeSettingCodeValueSet? »The location(s) at which this practitioner provides carelocation : Reference [0..*] « Location »The list of healthcare services that this worker provides for this role's Organization/Location(s)healthcareService : Reference [0..*] « HealthcareService »The contact details of communication devices available relevant to the specific PractitionerRole. This can include addresses, phone numbers, fax numbers, mobile numbers, email addresses and web sitescontact : ExtendedContactDetail [0..*]A collection of times the practitioner is available or performing this role at the location and/or healthcareserviceavailability : Availability [0..*]Technical endpoints providing access to services operated for the practitioner with this roleendpoint : Reference [0..*] « Endpoint »

XML Template

<PractitionerRole xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifiers that are specific to a role/location --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this practitioner role record is in active use -->
 <period><!-- 0..1 Period The period during which the practitioner is authorized to perform in these role(s) --></period>
 <practitioner><!-- 0..1 Reference(Practitioner) Practitioner that is able to provide the defined services for the organization --></practitioner>
 <organization><!-- 0..1 Reference(Organization) Organization where the roles are available --></organization>
 <code><!-- 0..* CodeableConcept Roles which this practitioner may perform --></code>
 <specialty><!-- 0..* CodeableConcept Specific specialty of the practitioner --></specialty>
 <location><!-- 0..* Reference(Location) The location(s) at which this practitioner provides care --></location>
 <healthcareService><!-- 0..* Reference(HealthcareService) The list of healthcare services that this worker provides for this role's Organization/Location(s) --></healthcareService>
 <contact><!-- 0..* ExtendedContactDetail Official contact details relating to this PractitionerRole --></contact>
 <availability><!-- 0..* Availability Times the Practitioner is available at this location and/or healthcare service (including exceptions) --></availability>
 <endpoint><!-- 0..* Reference(Endpoint) Technical endpoints providing access to services operated for the practitioner with this role --></endpoint>
</PractitionerRole>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:PractitionerRole;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:PractitionerRole.identifier [ Identifier ], ... ; # 0..* Business Identifiers that are specific to a role/location
  fhir:PractitionerRole.active [ boolean ]; # 0..1 Whether this practitioner role record is in active use
  fhir:PractitionerRole.period [ Period ]; # 0..1 The period during which the practitioner is authorized to perform in these role(s)
  fhir:PractitionerRole.practitioner [ Reference(Practitioner) ]; # 0..1 Practitioner that is able to provide the defined services for the organization
  fhir:PractitionerRole.organization [ Reference(Organization) ]; # 0..1 Organization where the roles are available
  fhir:PractitionerRole.code [ CodeableConcept ], ... ; # 0..* Roles which this practitioner may perform
  fhir:PractitionerRole.specialty [ CodeableConcept ], ... ; # 0..* Specific specialty of the practitioner
  fhir:PractitionerRole.location [ Reference(Location) ], ... ; # 0..* The location(s) at which this practitioner provides care
  fhir:PractitionerRole.healthcareService [ Reference(HealthcareService) ], ... ; # 0..* The list of healthcare services that this worker provides for this role's Organization/Location(s)
  fhir:PractitionerRole.contact [ ExtendedContactDetail ], ... ; # 0..* Official contact details relating to this PractitionerRole
  fhir:PractitionerRole.availability [ Availability ], ... ; # 0..* Times the Practitioner is available at this location and/or healthcare service (including exceptions)
  fhir:PractitionerRole.endpoint [ Reference(Endpoint) ], ... ; # 0..* Technical endpoints providing access to services operated for the practitioner with this role
]

Changes since R4

PractitionerRole
PractitionerRole.contact
  • Added Element
PractitionerRole.availability
  • Added Element
PractitionerRole.telecom
  • deleted
PractitionerRole.availableTime
  • deleted
PractitionerRole.notAvailable
  • deleted
PractitionerRole.availabilityExceptions
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. All tests pass round-trip testing and all r3 resources are valid.)

Structure

Name iconFlags iconCard. iconType iconDescription & Constraints icondoco icon
.. PractitionerRole TUDomainResourceRoles/organizations the practitioner is associated with

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierBusiness Identifiers that are specific to a role/location

... active Σ0..1booleanWhether this practitioner role record is in active use
... period Σ0..1PeriodThe period during which the practitioner is authorized to perform in these role(s)
... organization Σ0..1Reference(Organization)Organization where the roles are available
... code Σ0..*CodeableConceptRoles which this practitioner may perform
PractitionerRole (Example)

... specialty Σ0..*CodeableConceptSpecific specialty of the practitioner
Practice Setting Code Value Set (Preferred)

... location Σ0..*Reference(Location)The location(s) at which this practitioner provides care

... healthcareService 0..*Reference(HealthcareService)The list of healthcare services that this worker provides for this role's Organization/Location(s)

... contact 0..*ExtendedContactDetailOfficial contact details relating to this PractitionerRole

... availability 0..*AvailabilityTimes the Practitioner is available at this location and/or healthcare service (including exceptions)

... endpoint 0..*Reference(Endpoint)Technical endpoints providing access to services operated for the practitioner with this role


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

PractitionerRole (DomainResource)Business Identifiers that are specific to a role/locationidentifier : Identifier [0..*]Whether this practitioner role record is in active useactive : boolean [0..1]The period during which the person is authorized to act as a practitioner in these role(s) for the organizationperiod : Period [0..1]Practitioner that is able to provide the defined services for the organizationpractitioner : Reference [0..1] « Practitioner »The organization where the Practitioner performs the roles associatedorganization : Reference [0..1] « Organization »Roles which this practitioner is authorized to perform for the organizationcode : CodeableConcept [0..*] « null (Strength=Example)PractitionerRole?? »The specialty of a practitioner that describes the functional role they are practicing at a given organization or locationspecialty : CodeableConcept [0..*] « null (Strength=Preferred)PracticeSettingCodeValueSet? »The location(s) at which this practitioner provides carelocation : Reference [0..*] « Location »The list of healthcare services that this worker provides for this role's Organization/Location(s)healthcareService : Reference [0..*] « HealthcareService »The contact details of communication devices available relevant to the specific PractitionerRole. This can include addresses, phone numbers, fax numbers, mobile numbers, email addresses and web sitescontact : ExtendedContactDetail [0..*]A collection of times the practitioner is available or performing this role at the location and/or healthcareserviceavailability : Availability [0..*]Technical endpoints providing access to services operated for the practitioner with this roleendpoint : Reference [0..*] « Endpoint »

XML Template

<PractitionerRole xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifiers that are specific to a role/location --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this practitioner role record is in active use -->
 <period><!-- 0..1 Period The period during which the practitioner is authorized to perform in these role(s) --></period>
 <practitioner><!-- 0..1 Reference(Practitioner) Practitioner that is able to provide the defined services for the organization --></practitioner>
 <organization><!-- 0..1 Reference(Organization) Organization where the roles are available --></organization>
 <code><!-- 0..* CodeableConcept Roles which this practitioner may perform --></code>
 <specialty><!-- 0..* CodeableConcept Specific specialty of the practitioner --></specialty>
 <location><!-- 0..* Reference(Location) The location(s) at which this practitioner provides care --></location>
 <healthcareService><!-- 0..* Reference(HealthcareService) The list of healthcare services that this worker provides for this role's Organization/Location(s) --></healthcareService>
 <contact><!-- 0..* ExtendedContactDetail Official contact details relating to this PractitionerRole --></contact>
 <availability><!-- 0..* Availability Times the Practitioner is available at this location and/or healthcare service (including exceptions) --></availability>
 <endpoint><!-- 0..* Reference(Endpoint) Technical endpoints providing access to services operated for the practitioner with this role --></endpoint>
</PractitionerRole>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:PractitionerRole;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:PractitionerRole.identifier [ Identifier ], ... ; # 0..* Business Identifiers that are specific to a role/location
  fhir:PractitionerRole.active [ boolean ]; # 0..1 Whether this practitioner role record is in active use
  fhir:PractitionerRole.period [ Period ]; # 0..1 The period during which the practitioner is authorized to perform in these role(s)
  fhir:PractitionerRole.practitioner [ Reference(Practitioner) ]; # 0..1 Practitioner that is able to provide the defined services for the organization
  fhir:PractitionerRole.organization [ Reference(Organization) ]; # 0..1 Organization where the roles are available
  fhir:PractitionerRole.code [ CodeableConcept ], ... ; # 0..* Roles which this practitioner may perform
  fhir:PractitionerRole.specialty [ CodeableConcept ], ... ; # 0..* Specific specialty of the practitioner
  fhir:PractitionerRole.location [ Reference(Location) ], ... ; # 0..* The location(s) at which this practitioner provides care
  fhir:PractitionerRole.healthcareService [ Reference(HealthcareService) ], ... ; # 0..* The list of healthcare services that this worker provides for this role's Organization/Location(s)
  fhir:PractitionerRole.contact [ ExtendedContactDetail ], ... ; # 0..* Official contact details relating to this PractitionerRole
  fhir:PractitionerRole.availability [ Availability ], ... ; # 0..* Times the Practitioner is available at this location and/or healthcare service (including exceptions)
  fhir:PractitionerRole.endpoint [ Reference(Endpoint) ], ... ; # 0..* Technical endpoints providing access to services operated for the practitioner with this role
]

Changes since Release 4

PractitionerRole
PractitionerRole.contact
  • Added Element
PractitionerRole.availability
  • Added Element
PractitionerRole.telecom
  • deleted
PractitionerRole.availableTime
  • deleted
PractitionerRole.notAvailable
  • deleted
PractitionerRole.availabilityExceptions
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. All tests pass round-trip testing and all r3 resources are valid.)

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

PathDefinitionTypeReference
PractitionerRole.code

This example value set defines a set of codes that can be used to indicate the role of a Practitioner.

ExamplePractitionerRole
PractitionerRole.specialty

This is the code representing the clinical specialty of the clinician or provider who interacted with, treated, or provided a service to/for the patient. The value set used for clinical specialty has been limited by HITSP to the value set reproduced from HITSP C80 Table 2-149 Clinical Specialty Value Set Definition.

PreferredPracticeSettingCodeValueSet

  • There is no address on the PractitionerRole as the location that is defined here contains the address.
    This prevents having to duplicate the address values across multiple resources.
  • As briefly noted in the boundaries and relationships section the PractitionerRole resource can be used to represent multiple locations in the one resource instance, however this should be done with care. When representing multiple locations in an instance, and/or multiple specialties, all details apply to all locations. Using that approach you cannot differentiate a different contact number, different availabilities, or different services at each location.
    Hence maintaining these records needs to ensure that when changing a value, such as availability, it applies to all locations. If different values are required for the different locations, then a new instance will need to be created, and then split as appropriate. Existing resources referencing the original PractitionerRole instance will need to be updated to refer to the appropriate record.
    For this reason we expect that it will be common to profile the location element down to a single location, simplifying overall usage, and the availabilities are clear that they apply to this location, and any referenced healthcare services.

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
active NtokenWhether this practitioner role record is in active usePractitionerRole.active
datedateThe period during which the practitioner is authorized to perform in these role(s)PractitionerRole.period
emailtokenA value in an email contactPractitionerRole.contact.telecom.where(system='email')
endpointreferenceTechnical endpoints providing access to services operated for the practitioner with this rolePractitionerRole.endpoint
(Endpoint)
identifiertokenA practitioner's IdentifierPractitionerRole.identifier
locationreferenceOne of the locations at which this practitioner provides carePractitionerRole.location
(Location)
organizationreferenceThe identity of the organization the practitioner represents / acts on behalf ofPractitionerRole.organization
(Organization)
phonetokenA value in a phone contactPractitionerRole.contact.telecom.where(system='phone')
practitionerreferencePractitioner that is able to provide the defined services for the organizationPractitionerRole.practitioner
(Practitioner)
roletokenThe practitioner can perform this role at for the organizationPractitionerRole.code
servicereferenceThe list of healthcare services that this worker provides for this role's Organization/Location(s)PractitionerRole.healthcareService
(HealthcareService)
specialtytokenThe practitioner has this specialty at an organizationPractitionerRole.specialty
telecomtokenThe value in any kind of contactPractitionerRole.contact.telecom