Name Flags Card. Type Description & Constraints Consent C 0..* Consent A healthcare consumer's policy choices to permits or denies recipients or roles to perform actions for specific purposes and periods of time inv-dh-cons-01: If donation decision is 'permit', there SHALL be a specific organ (except.data.reference). inv-dh-cons-02: If donation decision is 'deny', there SHALL NOT be a specific organ (except.data.reference). inv-dh-cons-03: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/consent-aodr'. meta 1..1 Meta Metadata about the resource profile 1..* uri Profiles this resource claims to conform to Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url dateInitialRegistration S 0..1 dateTime Date the individual first registered URL: http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/extension-dateinitialregistration donationDecision S 1..1 CodeableConcept Individual's decision about donation URL: http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/extension-donationdecision Binding: https://healthterminologies.gov.au/fhir/ValueSet/organ-donation-consent-finding-1 (required) identifier S 1..1 Identifier Identifier for this record (external references) status S 1..1 code draft | proposed | active | rejected | inactive | entered-in-error Fixed Value: active Slices for category S 1..* CodeableConcept Classification of the consent statement - for indexing/retrieval Slice: Unordered, Open by pattern:$this category:organDonationConsent 1..1 CodeableConcept Classification of the consent statement - for indexing/retrieval Required Pattern: At least the following coding 1..* Coding Code defined by a terminology system Fixed Value: (complex) system 1..1 uri Identity of the terminology system Fixed Value: http://loinc.org code 1..1 code Symbol in syntax defined by the system Fixed Value: 64300-7 patient S 1..1 Reference(AU Base Patient) Who the consent applies to dateTime S 1..1 dateTime When this Consent was created or indexed consentingParty 0..* Reference(RelatedPerson | AU Base Organisation | AU Base Patient | AU Base Practitioner) Who is agreeing to the policy and exceptions actor 0..* BackboneElement Who|what controlled by this consent (or group, by role) reference 1..1 Reference(AU Base Device | Group | CareTeam | RelatedPerson | AU Base Organisation | AU Base Patient | AU Base Practitioner) Resource for the actor (or group, by role) organization 0..1 Reference(AU Base Organisation) Custodian of the consent policy S 1..1 BackboneElement Policies covered by this consent authority S 0..1 uri Enforcement source for policy Fixed Value: http://australianorgandonorregister.gov.au uri S 1..1 uri Specific policy covered by this consent Fixed Value: http://www.australianorgandonorregister.gov.au/aodr except S 0..* BackboneElement Individual's decision about donation of a specific organ or tissue. type S 1..1 code deny | permit actor 0..* BackboneElement Who|what controlled by this exception (or group, by role) reference 1..1 Reference(AU Base Device | Group | CareTeam | RelatedPerson | AU Base Organisation | AU Base Patient | AU Base Practitioner) Resource for the actor (or group, by role) action S 1..1 CodeableConcept Actions controlled by this exception Required Pattern: At least the following coding 1..* Coding Code defined by a terminology system Fixed Value: (complex) system 1..1 uri Identity of the terminology system Fixed Value: http://snomed.info/sct code 1..1 code Symbol in syntax defined by the system Fixed Value: 53958007 data S 1..1 BackboneElement The body site controlled by this exception. meaning 1..1 code instance | related | dependents | authoredby Fixed Value: instance reference S 1..1 Reference(ADHA Australian Organ Donor Register BodySite) {c} The actual data reference Documentation for this format
ADHA Australian Organ Donor Register Consent
The purpose of this profile is to define a representation of a record of organ and tissue donation decision held by the Australian Organ Donor Register for the electronic exchange of digital health information between Medicare repositories and the My Health Record system infrastructure in Australia.
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A healthcare consumer's policy choices to permits or denies recipients or roles to perform actions for specific purposes and periods of time
A record of a healthcare consumer’s policy 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.
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.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL NOT contain any narrative
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty()
not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))
exists(f:policy) or exists(f:policyRule)
If donation decision is 'permit', there SHALL be a specific organ (except.data.reference).
extension.where(url='http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/extension-donationdecision').value.coding.where(code='160654005').exists() implies except.exists()
If donation decision is 'deny', there SHALL NOT be a specific organ (except.data.reference).
extension.where(url='http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/extension-donationdecision').value.coding.where(code='161034004').exists() implies except.empty()
One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/consent-aodr'.
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional Content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. In order 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.
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.
The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
When the resource last changed - e.g. when the version changed.
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Security Labels from the Healthcare Privacy and Security Classification System.
Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource, and may 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.
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 in formation is added later.
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.
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.
The date the individual first registered.
All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
The individual's decision about donation.
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. Usually modifier elements provide negation or qualification. In order 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.
Identifier for this record (external references)
Unique identifier for this copy of the Consent Statement.
This identifier is 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.
draft | proposed | active | rejected | inactive | entered-in-error
Indicates the current state of this consent.
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.
The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.
Classification of the consent statement - for indexing/retrieval
A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.
A classification of the type of consents found in a consent statement
The patient/healthcare consumer to whom this consent applies.
Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.
Relevant time or time-period when this Consent is applicable.
This can be a subset of the period of the original statement.
When this Consent was created or indexed
When this Consent was issued / created / indexed.
This is not the time of the original consent, but the time that this statement was made or derived.
Who is agreeing to the policy and exceptions
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.
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.
Who|what controlled by this consent (or group, by role)
Who or what is controlled by this consent. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
There is no specific actor associated with the consent
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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
How the individual is involved in the resources content that is described in the consent.
How an actor is involved in the consent considerations
Resource for the actor (or group, by role)
The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').
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'.
The organization that manages the consent, and the framework within which it is executed.
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.
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.
The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.
Entity or Organization having regulatory jurisdiction or accountability for enforcing policies pertaining to Consent Directives.
This element is for discoverability / documentation, and does not modify or qualify the policy rules.
A referece to the specific computable policy.
If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.
Might be a unique identifier of a policy set in XACML, or other rules engine.
Security Labels that define affected resources
A set of security labels that define which resources are controlled by this consent. If more than one label is specified, all resources must have all the specified labels.
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. Not all of the security labels make sense for use in this element (may define a narrower value set?).
Context of activities for which the agreement is made
The context of the activities a user is taking - why the user is accessing the data - that are controlled by this consent.
This element is for discoverability / documentation, and does not modify or qualify the policy (e.g. the policy itself describes the purposes for which it applies).
What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels
Timeframe for data controlled by this consent
Clinical or Operational Relevant period of time that bounds the data controlled by this consent.
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.
The resources controlled by this consent, if specific resources are referenced.
instance | related | dependents | authoredby
How the resource reference is interpreted when testing consent restrictions.
How a resource reference is interpreted when testing consent restrictions
A reference to a specific resource that defines which resources are covered by this consent.
Individual's decision about donation of a specific organ or tissue.
Action to take - permit or deny - when the exception conditions are met.
How an exception statement is applied, such as adding additional consent or removing consent
The timeframe in this exception is valid.
Who|what controlled by this exception (or group, by role)
Who or what is controlled by this Exception. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').
There is no specific actor associated with the exception
How the individual is involved in the resources content that is described in the exception.
A set of security labels that define which resources are controlled by this exception. If more than one label is specified, all resources must have all the specified labels.
Context of activities covered by this exception
The context of the activities a user is taking - why the user is accessing the data - that are controlled by this exception.
E.g. if the purpose is 'research', then the operational context must be research, in order for the consent to apply. Not all of the security labels make sense for use in this element (may define a narrower value set?).
The class of information covered by this exception. 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.
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.
The class (type) of information a consent rule covers
e.g. LOINC or SNOMED CT code, etc in the content
If this code is found in an instance, then the exception applies.
Typical use of this is a Document code with class = CDA.
If this code is found in an instance, then the exception applies
Timeframe for data controlled by this exception
Clinical or Operational Relevant period of time that bounds the data controlled by this exception.
The body site controlled by this exception.
There is no specific actor associated with the consent.