Release 4 5 Preview #1

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). (v4.2.0: R5 Preview #1). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Patient Care Work Group Maturity Level : 2   Trial Use Security Category : Patient Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

Detailed Descriptions for the elements in the Communication resource.

Communication
Element Id Communication
Definition

An occurrence of information being transmitted; e.g. an alert that was sent to a responsible provider, a public health agency that was notified about communication to a provider/reporter in response to a case report for a reportable condition.

Cardinality 0..*
Type DomainResource
Communication.identifier
Element Id Communication.identifier
Definition

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

Note This is a business identifier, not a resource identifier (see discussion )
Cardinality 0..*
Type Identifier
Requirements

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

Summary true
Comments

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

Communication.instantiatesCanonical
Element Id Communication.instantiatesCanonical
Definition

The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.

Cardinality 0..*
Type canonical ( PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire )
Summary true
Communication.instantiatesUri
Element Id Communication.instantiatesUri
Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Communication.

Cardinality 0..*
Type uri
Summary true
Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

Communication.basedOn
Element Id Communication.basedOn
Definition

An order, proposal or plan fulfilled in whole or in part by this Communication.

Cardinality 0..*
Type Reference ( Any )
Alternate Names fulfills
Summary true
Comments

This must point to some sort of a 'Request' resource, such as CarePlan, CommunicationRequest, ServiceRequest, MedicationRequest, etc.

Communication.partOf
Element Id Communication.partOf
Definition

Part A larger event (e.g. Communication, Procedure) of which this action. particular communication is a component or step.

Cardinality 0..*
Type Reference ( Any )
Alternate Names container
Summary true
Comments

The event the communication was part of - e.g. if you disclosed as "part" of counselling, it would be partOf that Procedure.

Communication.inResponseTo
Element Id Communication.inResponseTo
Definition

Prior communication that this communication is in response to.

Cardinality 0..*
Type Reference ( Communication )
Communication.status
Element Id Communication.status
Definition

The status of the transmission.

Cardinality 1..1
Terminology Binding EventStatus ( Required )
Type code
Is Modifier true (Reason: 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)
Summary true
Comments

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

Communication.statusReason
Element Id Communication.statusReason
Definition

Captures the reason for the current state of the Communication.

Cardinality 0..1
Terminology Binding CommunicationNotDoneReason ( Example )
Type CodeableConcept
Alternate Names Suspended Reason; Cancelled Reason
Summary true
Comments

This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

Communication.category
Element Id Communication.category
Definition

The type of message conveyed such as alert, notification, reminder, instruction, etc.

Cardinality 0..*
Terminology Binding CommunicationCategory ( Example )
Type CodeableConcept
Comments

There may be multiple axes of categorization and one communication may serve multiple purposes.

Communication.priority
Element Id Communication.priority
Definition

Characterizes how quickly the planned or in progress communication must be addressed. Includes concepts such as stat, urgent, routine.

Cardinality 0..1
Terminology Binding Request priority ( Required )
Type code
Meaning if Missing If missing, this communication should be treated with normal priority
Summary true
Comments

Used to prioritize workflow (such as which communication to read first) when the communication is planned or in progress.

Communication.medium
Element Id Communication.medium
Definition

A channel that was used for this communication (e.g. email, fax).

Cardinality 0..*
Terminology Binding v3 Code System ParticipationMode ( Example )
Type CodeableConcept
Communication.subject
Element Id Communication.subject
Definition

The patient or group that was the focus of this communication.

Cardinality 0..1
Type Reference ( Patient | Group )
Patterns Reference(Patient,Group): Common patterns = Participant
Alternate Names patient
Summary true
Communication.topic
Element Id Communication.topic
Definition

Description of the purpose/content, similar to a subject line in an email.

Cardinality 0..1
Terminology Binding CommunicationTopic ( Example )
Type CodeableConcept
Comments

Communication.topic.text can be used without any codings.

Communication.about
Element Id Communication.about
Definition

Other resources that pertain to this communication and to which this communication should be associated.

Cardinality 0..*
Type Reference ( Any )
Comments

Don't use Communication.about element when a more specific element exists, such as basedOn or reasonReference.

Communication.encounter
Element Id Communication.encounter
Definition

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

Cardinality 0..1
Type Reference ( Encounter )
Summary true
Comments

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

Communication.sent
Element Id Communication.sent
Definition

The time when this communication was sent.

Cardinality 0..1
Type dateTime
Communication.received
Element Id Communication.received
Definition

The time when this communication arrived at the destination.

Cardinality 0..1
Type dateTime
Communication.recipient
Element Id Communication.recipient
Definition

The entity (e.g. person, organization, clinical information system, care team or device) which was is the target of the communication. If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).

Cardinality 0..*
Type Reference ( CareTeam | Device | Group | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | Group | CareTeam | HealthcareService Endpoint )
Patterns Reference(CareTeam,Device,Group,HealthcareService,Location,Organization,Patient,Practitioner,PractitionerRole,RelatedPerson,Endpoint): No common pattern
Comments

If receipts need to be tracked by an individual, a separate resource instance will need to be created for each recipient. Multiple recipient communications are intended where either receipts are not tracked (e.g. a mass mail-out) or a receipt is captured in aggregate (all emails confirmed received by a particular time).

Communication.sender
Element Id Communication.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which was is the source of the communication.

Cardinality 0..1
Type Reference ( Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService | Endpoint )
Patterns Reference(Device,Organization,Patient,Practitioner,PractitionerRole,RelatedPerson,HealthcareService,Endpoint): No common pattern
Communication.reasonCode Communication.reason
Element Id Communication.reasonCode Communication.reason
Definition

The reason or justification for the communication.

Cardinality 0..*
Terminology Binding SNOMED CT Clinical Findings ( Example )
Type CodeableConcept CodeableReference ( Any )
Summary true
Comments

Textual reasons can be captured using reasonCode.text. reason.concept.text.

Communication.reasonReference Element Id Communication.reasonReference Definition Indicates another resource whose existence justifies this communication. Cardinality 0..* Type Reference ( Condition | Observation | DiagnosticReport | DocumentReference ) Summary true Communication.payload
Element Id Communication.payload
Definition

Text, attachment(s), or resource(s) that was communicated to the recipient.

Cardinality 0..*
Communication.payload.content[x]
Element Id Communication.payload.content[x]
Definition

A communicated content (or for multi-part communications, one portion of the communication).

Cardinality 1..1
Type string | Attachment | Reference ( Any ) )| CodeableConcept
[x] Note See Choice of Data Types for further information about how to use [x]
Comments

The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate.

If the content isn't codified, contentCodeableConcept.text can be used.

When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.

Communication.note
Element Id Communication.note
Definition

Additional notes or commentary about the communication by the sender, receiver or other interested parties.

Cardinality 0..*
Type Annotation