DSTU2 STU 3 Candidate
This page is part of the FHIR Specification (v1.0.2: DSTU 2). The current version which supercedes this version is

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . For a full list of available versions, see the Directory of published versions . Page versions: . Page versions: R5 R4B R4 R3 R2

5.21 5.23 Resource Communication - Content Resource Communication - Content

An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency was notified about a reportable condition.
Patient Care Patient Care Work Group Work Group Maturity Level : 1 Maturity Level : 1 Compartments : : Device , , Encounter , , Patient , , Practitioner , , RelatedPerson

An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency was notified about a reportable condition.

5.21.1 Scope and Usage 5.23.1 Scope and Usage This resource is a record of a communication. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The sender and receivers may be patients, practitioners, related persons, organizations, or devices. Communication use cases include: A reminder or alert delivered to a responsible provider A recorded notification from the nurse that a patient's temperature exceeds a value A notification to a public health agency of a patient presenting with a communicable disease reportable to the public health agency Patient educational material sent by a provider to a patient Non-patient specific communication use cases may include: A nurse call from a hall bathroom Advisory for battery service from a pump

This resource is a record of a communication. A communication is a conveyance of information from one entity, a sender, to another entity, a receiver. The sender and receivers may be patients, practitioners, related persons, organizations, or devices. Communication use cases include:

  • A reminder or alert delivered to a responsible provider
  • A recorded notification from the nurse that a patient's temperature exceeds a value
  • A notification to a public health agency of a patient presenting with a communicable disease reportable to the public health agency
  • Patient educational material sent by a provider to a patient

Non-patient specific communication use cases may include:

  • A nurse call from a hall bathroom
  • Advisory for battery service from a pump

5.21.2 Boundaries and Relationships 5.23.2 Boundaries and Relationships This resource is a record of a communication that has occurred. It does not represent the actual flow of communication. While

This resource is a record of a communication that has occurred. It does not represent the actual flow of communication. While AuditEvent can track electronic disclosures of information, it cannot track conversations, phone calls, letters and other interactions that are not system-to-system. And even for system-to-system communications, the specific end recipients may not be known. As well, can track electronic disclosures of information, it cannot track conversations, phone calls, letters and other interactions that are not system-to-system. And even for system-to-system communications, the specific end recipients may not be known. As well, AuditEvents are not considered to be "part" of the patient record, while are not considered to be "part" of the patient record, while Communication instances are. The instances are. The Communication resource is not used as a general audit mechanism to track every disclosure of every record. Rather, it is used when a clinician or other user wants to ensure a record of a particular communication is itself maintained as part of the reviewable health record. resource is not used as a general audit mechanism to track every disclosure of every record. Rather, it is used when a clinician or other user wants to ensure a record of a particular communication is itself maintained as part of the reviewable health record.

Flag resources represent a continuous ongoing "communication" alerting anyone dealing with the patient of certain precautions to take or issues to be aware of. The flags are continuously present as an ongoing reminder. This is distinct from resources represent a continuous ongoing "communication" alerting anyone dealing with the patient of certain precautions to take or issues to be aware of. The flags are continuously present as an ongoing reminder. This is distinct from Communication where there is a specific intended sender and receiver and the information is delivered only once. where there is a specific intended sender and receiver and the information is delivered only once.

Communication and Encounter Communication and Encounter The Communication is about the transfer of information (which may or may not occur as part of an encounter), while Encounter is about the coming together (in person or virtually) of a Patient with a Practitioner. Communication does not deal with the duration of a call, it represents the fact that information was transferred at a particular point in time. The phone calls involving the Patient should be handled using

The Communication is about the transfer of information (which may or may not occur as part of an encounter), while Encounter is about the coming together (in person or virtually) of a Patient with a Practitioner. Communication does not deal with the duration of a call, it represents the fact that information was transferred at a particular point in time.

The phone calls involving the Patient should be handled using Encounter . Phone calls not involving the patient (e.g. between practitioners or practitioner to relative) that are tracked for billing or other purposes can use Communication to represent the information transferred, but are not ideal to represent the call itself. A better mechanism for handling such calls will be explored in a future release. . Phone calls not involving the patient (e.g. between practitioners or practitioner to relative) that are tracked for billing or other purposes can use Communication to represent the information transferred, but are not ideal to represent the call itself. A better mechanism for handling such calls will be explored in a future release.

5.21.3 Resource Content 5.23.3 Resource Content

Structure

Name Flags Card. Type Description & Constraints Description & Constraints doco
. . Communication Σ DomainResource A record of information transmitted from a sender to a receiver A record of information transmitted from a sender to a receiver
. . . identifier Σ 0..* Identifier Unique identifier Unique identifier
. . . category Σ 0..1 CodeableConcept Message category Message category
. . . sender Σ 0..1 Reference ( Device | | Organization | | Patient | | Practitioner | | RelatedPerson ) Message sender Message sender
. . . recipient Σ 0..* Reference ( Device | | Organization | | Patient | | Practitioner | | RelatedPerson | | Group ) Message recipient Message recipient
. . . payload Σ 0..* BackboneElement Message payload Message payload
. . . . content[x] Σ 1..1 Message part content Message part content
. . . . . contentString string
. . . . . contentAttachment Attachment
. . . . contentReference . contentReference Reference ( Any )
. . . medium Σ 0..* CodeableConcept A channel of communication A channel of communication
v3 Code System ParticipationMode ( v3 Code System ParticipationMode ( Example )
. . . status ?! ?! Σ 0..1 code in-progress | completed | suspended | rejected | failed in-progress | completed | suspended | rejected | failed
CommunicationStatus ( ( Required )
. . . encounter Σ 0..1 Reference ( Encounter ) Encounter leading to message Encounter leading to message
. . . sent Σ 0..1 dateTime When sent When sent
. . . received Σ 0..1 dateTime When received When received
. . . reason Σ 0..* CodeableConcept Indication for message Indication for message
. . . subject Σ 0..1 Reference ( Patient ) Focus of message Focus of message
. . . requestDetail Σ 0..1 Reference ( CommunicationRequest ) CommunicationRequest producing this message CommunicationRequest producing this message

Documentation for this format doco Documentation for this format

UML Diagram UML Diagram

Communication ( ( DomainResource ) Identifiers associated with this Communication that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation) Identifiers associated with this Communication that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation) identifier : : Identifier [0..*] [0..*] The type of message conveyed such as alert, notification, reminder, instruction, etc The type of message conveyed such as alert, notification, reminder, instruction, etc category : : CodeableConcept [0..1] [0..1] The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication sender : : Reference [0..1] « [0..1] « Device | Organization | Patient | Practitioner | RelatedPerson » » The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient.  Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time) The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient.  Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time) recipient : : Reference [0..*] « [0..*] « Device | Organization | Patient | Practitioner | RelatedPerson | Group » » A channel that was used for this communication (e.g. email, fax) A channel that was used for this communication (e.g. email, fax) medium : : CodeableConcept [0..*] « [0..*] « Codes for communication mediums such as phone, fax, email, in person, etc. (Strength=Example) Codes for communication mediums such as phone, fax, email, in person, etc. (Strength=Example) v3 Code System ParticipationM... v3 Code System ParticipationM... ?? » ?? » The status of the transmission (this element modifies the meaning of other elements) The status of the transmission (this element modifies the meaning of other elements) status : : code [0..1] « [0..1] « The status of the communication. (Strength=Required) The status of the communication. (Strength=Required) CommunicationStatus ! » ! » The encounter within which the communication was sent The encounter within which the communication was sent encounter : : Reference [0..1] « [0..1] « Encounter » » The time when this communication was sent The time when this communication was sent sent : : dateTime [0..1] [0..1] The time when this communication arrived at the destination The time when this communication arrived at the destination received : : dateTime [0..1] [0..1] The reason or justification for the communication The reason or justification for the communication reason : : CodeableConcept [0..*] [0..*] The patient who was the focus of this communication The patient who was the focus of this communication subject : : Reference [0..1] « [0..1] « Patient » » The communication request that was responsible for producing this communication The communication request that was responsible for producing this communication requestDetail : : Reference [0..1] « [0..1] « CommunicationRequest » » Payload A communicated content (or for multi-part communications, one portion of the communication) A communicated content (or for multi-part communications, one portion of the communication) content[x] : : Type [1..1] « [1..1] « string | Attachment | Reference ( Any ) » ) » Text, attachment(s), or resource(s) that was communicated to the recipient Text, attachment(s), or resource(s) that was communicated to the recipient payload [0..*]

XML Template XML Template 

<Communication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier --></identifier>
 <category><!-- 0..1 CodeableConcept Message category --></category>
 <sender><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson) Message sender --></sender>
 <|

 <recipient><!-- 0..* Reference(Device|Organization|Patient|Practitioner|

   RelatedPerson|Group) Message recipient --></recipient>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <</medium>

 <medium><!-- 0..* CodeableConcept A channel of communication --></medium>

 <status value="[code]"/><!-- 0..1 in-progress | completed | suspended | rejected | failed -->
 <encounter><!-- 0..1 Reference(Encounter) Encounter leading to message --></encounter>
 <sent value="[dateTime]"/><!-- 0..1 When sent -->
 <received value="[dateTime]"/><!-- 0..1 When received -->
 <reason><!-- 0..* CodeableConcept Indication for message --></reason>
 <subject><!-- 0..1 Reference(Patient) Focus of message --></subject>
 <requestDetail><!-- 0..1 Reference(CommunicationRequest) CommunicationRequest producing this message --></requestDetail>
</Communication>

Structure

Name Flags Card. Type Description & Constraints Description & Constraints doco
. . Communication Σ DomainResource A record of information transmitted from a sender to a receiver A record of information transmitted from a sender to a receiver
. . . identifier Σ 0..* Identifier Unique identifier Unique identifier
. . . category Σ 0..1 CodeableConcept Message category Message category
. . . sender Σ 0..1 Reference ( Device | | Organization | | Patient | | Practitioner | | RelatedPerson ) Message sender Message sender
. . . recipient Σ 0..* Reference ( Device | | Organization | | Patient | | Practitioner | | RelatedPerson | | Group ) Message recipient Message recipient
. . . payload Σ 0..* BackboneElement Message payload Message payload
. . . . content[x] Σ 1..1 Message part content Message part content
. . . . . contentString string
. . . . . contentAttachment Attachment
. . . . contentReference . contentReference Reference ( Any )
. . . medium Σ 0..* CodeableConcept A channel of communication A channel of communication
v3 Code System ParticipationMode ( v3 Code System ParticipationMode ( Example )
. . . status ?! ?! Σ 0..1 code in-progress | completed | suspended | rejected | failed in-progress | completed | suspended | rejected | failed
CommunicationStatus ( ( Required )
. . . encounter Σ 0..1 Reference ( Encounter ) Encounter leading to message Encounter leading to message
. . . sent Σ 0..1 dateTime When sent When sent
. . . received Σ 0..1 dateTime When received When received
. . . reason Σ 0..* CodeableConcept Indication for message Indication for message
. . . subject Σ 0..1 Reference ( Patient ) Focus of message Focus of message
. . . requestDetail Σ 0..1 Reference ( CommunicationRequest ) CommunicationRequest producing this message CommunicationRequest producing this message

Documentation for this format doco Documentation for this format

UML Diagram UML Diagram

Communication ( ( DomainResource ) Identifiers associated with this Communication that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation) Identifiers associated with this Communication that are defined by business processes and/ or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation) identifier : : Identifier [0..*] [0..*] The type of message conveyed such as alert, notification, reminder, instruction, etc The type of message conveyed such as alert, notification, reminder, instruction, etc category : : CodeableConcept [0..1] [0..1] The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication The entity (e.g. person, organization, clinical information system, or device) which was the source of the communication sender : : Reference [0..1] « [0..1] « Device | Organization | Patient | Practitioner | RelatedPerson » » The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient.  Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time) The entity (e.g. person, organization, clinical information system, or device) which was the target of the communication. If receipts need to be tracked by individual, a separate resource instance will need to be created for each recipient.  Multiple recipient communications are intended where either a receipt(s) is not tracked (e.g. a mass mail-out) or is captured in aggregate (all emails confirmed received by a particular time) recipient : : Reference [0..*] « [0..*] « Device | Organization | Patient | Practitioner | RelatedPerson | Group » » A channel that was used for this communication (e.g. email, fax) A channel that was used for this communication (e.g. email, fax) medium : : CodeableConcept [0..*] « [0..*] « Codes for communication mediums such as phone, fax, email, in person, etc. (Strength=Example) Codes for communication mediums such as phone, fax, email, in person, etc. (Strength=Example) v3 Code System ParticipationM... v3 Code System ParticipationM... ?? » ?? » The status of the transmission (this element modifies the meaning of other elements) The status of the transmission (this element modifies the meaning of other elements) status : : code [0..1] « [0..1] « The status of the communication. (Strength=Required) The status of the communication. (Strength=Required) CommunicationStatus ! » ! » The encounter within which the communication was sent The encounter within which the communication was sent encounter : : Reference [0..1] « [0..1] « Encounter » » The time when this communication was sent The time when this communication was sent sent : : dateTime [0..1] [0..1] The time when this communication arrived at the destination The time when this communication arrived at the destination received : : dateTime [0..1] [0..1] The reason or justification for the communication The reason or justification for the communication reason : : CodeableConcept [0..*] [0..*] The patient who was the focus of this communication The patient who was the focus of this communication subject : : Reference [0..1] « [0..1] « Patient » » The communication request that was responsible for producing this communication The communication request that was responsible for producing this communication requestDetail : : Reference [0..1] « [0..1] « CommunicationRequest » » Payload A communicated content (or for multi-part communications, one portion of the communication) A communicated content (or for multi-part communications, one portion of the communication) content[x] : : Type [1..1] « [1..1] « string | Attachment | Reference ( Any ) » ) » Text, attachment(s), or resource(s) that was communicated to the recipient Text, attachment(s), or resource(s) that was communicated to the recipient payload [0..*]

XML Template XML Template 

<Communication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Unique identifier --></identifier>
 <category><!-- 0..1 CodeableConcept Message category --></category>
 <sender><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   RelatedPerson) Message sender --></sender>
 <|

 <recipient><!-- 0..* Reference(Device|Organization|Patient|Practitioner|

   RelatedPerson|Group) Message recipient --></recipient>
 <payload>  <!-- 0..* Message payload -->
  <content[x]><!-- 1..1 string|Attachment|Reference(Any) Message part content --></content[x]>
 </payload>
 <</medium>

 <medium><!-- 0..* CodeableConcept A channel of communication --></medium>

 <status value="[code]"/><!-- 0..1 in-progress | completed | suspended | rejected | failed -->
 <encounter><!-- 0..1 Reference(Encounter) Encounter leading to message --></encounter>
 <sent value="[dateTime]"/><!-- 0..1 When sent -->
 <received value="[dateTime]"/><!-- 0..1 When received -->
 <reason><!-- 0..* CodeableConcept Indication for message --></reason>
 <subject><!-- 0..1 Reference(Patient) Focus of message --></subject>
 <requestDetail><!-- 0..1 Reference(CommunicationRequest) CommunicationRequest producing this message --></requestDetail>
</Communication>

  Alternate definitions:

Alternate definitions: Schema / Schematron , Resource Profile ( , Resource Profile ( XML , , JSON ), ), Questionnaire

5.21.3.1 Terminology Bindings 5.23.3.1 Terminology Bindings

Path Definition Type Reference
Communication.category Communication.category Codes for general categories of communications such as alerts, instruction, etc. Codes for general categories of communications such as alerts, instruction, etc. Unknown No details provided yet No details provided yet
Communication.medium Communication.medium Codes for communication mediums such as phone, fax, email, in person, etc. Codes for communication mediums such as phone, fax, email, in person, etc. Example v3 Code System ParticipationMode v3 Code System ParticipationMode
Communication.status Communication.status The status of the communication. The status of the communication. Required CommunicationStatus
Communication.reason Communication.reason Codes for describing reasons for the occurrence of a communication. Codes for describing reasons for the occurrence of a communication. Unknown No details provided yet Notes to reviewers: At this time, the code bindings are placeholders to be fleshed out upon further review by the community. No details provided yet

Notes to reviewers:

At this time, the code bindings are placeholders to be fleshed out upon further review by the community.

5.21.3.2 5.23.3.2 Communication.sender and Communication.recepient Communication.sender and Communication.recepient Communication.sender and Communication.recipient allow Patient|Practitioner|RelatedPerson - but it is not unusual to have a communication target - even a defined one - where it is unknown what kind of role the person is playing. If the communication is to or from an individual, whose role is not known (practitioner, patient or related person), - for example, only email address is captured in the system; then RelatedPerson should be used by default.

Communication.sender and Communication.recipient allow Patient|Practitioner|RelatedPerson - but it is not unusual to have a communication target - even a defined one - where it is unknown what kind of role the person is playing.

If the communication is to or from an individual, whose role is not known (practitioner, patient or related person), - for example, only email address is captured in the system; then RelatedPerson should be used by default.

5.21.4 Search Parameters 5.23.4 Search Parameters Search parameters for this resource. The common parameters also apply. See

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

© HL7.org 2011+. FHIR DSTU2 (v1.0.2-7202) generated on Sat, Oct 24, 2015 07:43+1100. Links: Search
Name Type Description Paths
category token Message category Message category Communication.category
encounter reference Encounter leading to message Encounter leading to message Communication.encounter
( Encounter )
identifier token Unique identifier Unique identifier Communication.identifier
medium token A channel of communication A channel of communication Communication.medium
patient reference Focus of message Focus of message Communication.subject
( Patient )
received date When received When received Communication.received
recipient reference Message recipient Message recipient Communication.recipient
( Device , , Patient , , Organization , , Practitioner , , Group , , RelatedPerson )
request reference CommunicationRequest producing this message CommunicationRequest producing this message Communication.requestDetail
( CommunicationRequest )
sender reference Message sender Message sender Communication.sender
( Device , , Patient , , Organization , , Practitioner , , RelatedPerson )
sent date When sent When sent Communication.sent
status token in-progress | completed | suspended | rejected | failed in-progress | completed | suspended | rejected | failed Communication.status
subject reference Focus of message Focus of message Communication.subject
( Patient )