Guidance on how to interpret the contents of this table can be found here
| 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. |
| Short | A 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. |
| Control | 0..* |
| Is Modifier | false |
| Summary | false |
| Invariants | dom-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. |
| Short | A 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. |
| Control | 0..1 |
| Type | uri |
| Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 4. Consent.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional 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. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-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()) |
| Slicing | This element introduces a set of slices on Consent.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 6. Consent.extension:consent_to_reuse_data | |
| Slice Name | consent_to_reuse_data |
| Definition | ERDRI-CDS - Consent to the reuse of data. |
| Short | Consent to Reuse Data |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(Consent to Reuse Data) (Extension Type: CodeableConcept) |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-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()) |
| 8. Consent.extension:agreement_to_be_contacted | |
| Slice Name | agreement_to_be_contacted |
| Definition | ERDRI-CDS - Agreement to be contacted for research purposes. |
| Short | Agreement to Be Contacted |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(Agreement to Be Contacted) (Extension Type: CodeableConcept) |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-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()) |
| 10. 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). |
| Short | Extensions 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. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
| Summary | false |
| 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 Names | extensions, user content |
| Invariants | ele-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()) |
| 12. Consent.status | |
| Definition | Indicates the current state of this consent. |
| Short | draft | 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. |
| Control | 1..1 |
| Binding | The 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. |
| Type | code |
| Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 14. Consent.scope | |
| Definition | A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible. |
| Short | Which of the four areas this resource covers (extensible) |
| Control | 1..1 |
| Binding | Unless not suitable, these codes SHALL be taken from ConsentScopeCodeshttp://hl7.org/fhir/ValueSet/consent-scope (extensible to http://hl7.org/fhir/ValueSet/consent-scope)The four anticipated uses for the Consent Resource. |
| Type | CodeableConcept |
| Is Modifier | true because Allows changes to codes based on scope selection |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 16. Consent.category | |
| Definition | A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements. |
| Short | Classification of the consent statement - for indexing/retrieval |
| Control | 1..1* |
| Binding | Unless not suitable, these codes SHALL be taken from ConsentCategoryCodeshttp://hl7.org/fhir/ValueSet/consent-category (extensible to http://hl7.org/fhir/ValueSet/consent-category)A classification of the type of consents found in a consent statement. |
| Type | CodeableConcept |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 18. Consent.patient | |
| Definition | The patient/healthcare consumer to whom this consent applies. |
| Short | Who 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. |
| Control | 10..1 |
| Type | Reference(RareLink IPS Patient, Patient) |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 20. 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. |
| Short | 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. |
| Control | 0..1 This element is affected by the following invariants: ref-1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 22. 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. |
| Short | Logical 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). |
| Note | This is a business identifier, not a resource identifier (see discussion) |
| Control | 0..1 |
| Type | Identifier |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 24. 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. |
| Short | Policies covered by this consent |
| Control | 10..1* |
| Type | BackboneElement |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 26. 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). |
| Short | Extensions 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. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| 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 Names | extensions, user content, modifiers |
| Invariants | ele-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()) |