| Australian Digital Health Agency FHIR Implementation Guide 1.0.0

Australian Digital Health Agency FHIR Implementation Guide. This is the current published version. It is based on FHIR® version 4.0.1. See the Directory of published versions for a list of available versions.

#### StructureDefinition: ADHA Core Practitioner - Detailed Descriptions

Definitions for the dh-practitioner-core-1 Profile.

1. Practitioner
Definition | A person who is directly or indirectly involved in the provisioning of healthcare.
Control | 0..*
2. Practitioner.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
3. Practitioner.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Control | 0..1
Type | Meta
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Practitioner.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.
Control | 0..1
Type | uri
Is Modifier | true
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.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Practitioner.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages A human language
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Comments | 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).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Practitioner.text
Definition | A human-readable narrative that contains a summary of the resource and can 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.
Control | 0..1
Type | Narrative
Alternate Names | narrativehtmlxhtmldisplay
Comments | 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 information is added later.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Practitioner.contained
Definition | 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.
Control | 0..*
Type | Resource
Alternate Names | inline resourcesanonymous resourcescontained resources
Comments | 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
8. Practitioner.extension
Definition | 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.
Control | 0..*
Type | Extension
Alternate Names | extensionsuser content
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.
Invariants | Defined on this element 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())
9. Practitioner.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).
Control | 0..*
Type | Extension
Is Modifier | 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 | extensionsuser content
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.
Invariants | Defined on this element 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())
10. Practitioner.identifier
Definition | An identifier that applies to this person in this role.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..* This element is affected by the following invariants: ele-1
Type | Identifier(Identifier AUHPII AUPBSPrescriberNumber AUCareAgencyEmployeeIdentifier AUAHPRARegistrationNumber)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Requirements | Often, specific identities are assigned for the agent.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on Practitioner.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators: pattern @ type
11. Practitioner.identifier:hpii
SliceName | hpii
Definition | Healthcare Provider Identifier for Individuals (HPI-I) assigned under the HI Service to healthcare providers involved in providing patient care.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Identifier(AUHPII)
Must Support | true
Requirements | Often, specific identities are assigned for the agent.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) inv-hpii-0: HPI-I shall be 16 digits (: value.matches('^([0-9]{16})$')) inv-hpii-1: HPI-I prefix shall be 800361 (: value.startsWith('800361')) inv-hpii-2: HPI-I shall pass the Luhn algorithm check (: (((select(value.substring(0,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(1,1).toInteger())+(select(value.substring(2,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(3,1).toInteger())+(select(value.substring(4,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(5,1).toInteger())+(select(value.substring(6,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(7,1).toInteger())+(select(value.substring(8,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(9,1).toInteger())+(select(value.substring(10,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(11,1).toInteger())+(select(value.substring(12,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(13,1).toInteger())+(select(value.substring(14,1).toInteger()).select(iif($this<5, $this*2, (($this*2)-9))))+(value.substring(15,1).toInteger()))mod 10=0))
12. Practitioner.active
Definition | Whether this practitioner's record is in active use.
Control | 0..1
Type | boolean
Requirements | Need to be able to mark a practitioner record as not to be used because it was created in error.
Comments | If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.
Meaning if Missing | This resource is generally assumed to be active if no value is provided for the active element
Fixed Value | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Practitioner.name
Definition | The name(s) associated with the practitioner.
Control | 1..* This element is affected by the following invariants: inv-dh-prac-01
Type | HumanName
Must Support | true
Requirements | The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.
Comments | The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate. In general, select the value to be used in the ResourceReference.display based on this: There is more than 1 name Use = usual Period is current to the date of the usage Use = official Other order as decided by internal business rules.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) inv-dh-prac-01: At least text or family name shall be present (: text.exists() or family.exists())
14. Practitioner.telecom
Definition | A contact detail for the practitioner, e.g. a telephone number or an email address.
Control | 0..*
Type | ContactPoint
Must Support | true
Requirements | Need to know how to reach a practitioner independent to any roles the practitioner may have.
Comments | Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Practitioner.address
Definition | Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.
Control | 0..* This element is affected by the following invariants: ele-1
Type | Address(Address AustralianAddress)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Requirements | The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.
Comments | The address is intended to describe postal addresses for administrative purposes, not to describe absolute geographical coordinates. Postal addresses are often used as proxies for physical locations (also see the Location resource).
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Practitioner.gender
Definition | Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.
Control | 0..1
Binding | The codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes
Type | code
Requirements | Needed to address the person correctly.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Practitioner.birthDate
Definition | The date of birth for the practitioner.
Control | 0..1
Type | date
Requirements | Needed for identification.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. Practitioner.photo
Definition | Image of the person.
Control | 0..*
Type | Attachment
Requirements | Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Practitioner.qualification
Definition | The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.
Control | 0..*
Type | BackboneElement
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) inv-dh-prac-02: If present, an issuer shall at least have a reference that conforms to ADHA Core Organization, an identifier or a display (: issuer.exists() implies issuer.all(($this.reference.resolve().conformsTo('http://ns.electronichealth.net.au/fhir/StructureDefinition/organization-core-1')) or $this.identifier.exists() or $this.display.exists())) inv-pra-0: A qualification shall only have AHPRA Profession details if the code is AHPRA Profession (: extension('http://hl7.org.au/fhir/StructureDefinition/ahpraprofession-details').exists() implies code.coding.where(system='http://terminology.hl7.org.au/CodeSystem/v2-0360' and code='AUAHPRAProfession').exists()) inv-pra-1: A qualification shall only have AHPRA Registration details if the code is AHPRA Registration (: extension('http://hl7.org.au/fhir/StructureDefinition/ahpraregistration-details').exists() implies code.coding.where(system='http://terminology.hl7.org.au/CodeSystem/v2-0360' and code='AUAHPRARegistration').exists())
20. Practitioner.qualification.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
XML Representation | In the XML format, this property is represented as an attribute.
21. Practitioner.qualification.extension
Definition | An Extension
Control | 0..*
Type | Extension
Invariants | Defined on this element 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 Practitioner.qualification.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
22. Practitioner.qualification.extension:ahpraProfession-details
SliceName | ahpraProfession-details
Definition | An Extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(AHPRAProfessionDetails) (Complex Extension)
Invariants | Defined on this element 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())
23. Practitioner.qualification.extension:ahpraRegistration-details
SliceName | ahpraRegistration-details
Definition | Details on the AHPRA registration of profession.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(AHPRARegistrationDetails) (Complex Extension)
Invariants | Defined on this element 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())
24. Practitioner.qualification.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).
Control | 0..*
Type | Extension
Is Modifier | 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 | extensionsuser contentmodifiers
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.
Invariants | Defined on this element 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())
25. Practitioner.qualification.identifier
Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..* This element is affected by the following invariants: ele-1
Type | Identifier(Identifier AUAHPRARegistrationNumber)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Requirements | Often, specific identities are assigned for the qualification.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Practitioner.qualification.code
Definition | Coded representation of the qualification.
Control | 1..1
Binding | The codes SHOULD be taken from hl7VS-degreeLicenseCertificate - AU Extended
Type | CodeableConcept
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Practitioner.qualification.period
Definition | Period during which the qualification is valid.
Control | 0..1
Type | Period
Must Support | true
Requirements | Qualifications are often for a limited period of time, and can be revoked.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Practitioner.qualification.issuer
Definition | Organization that regulates and issues the qualification.
Control | 0..1 This element is affected by the following invariants: inv-dh-prac-02
Type | Reference(Organization))
Must Support | true
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Practitioner.communication
Definition | A language the practitioner can use in patient communication.
Control | 0..*
Binding | The codes SHALL be taken from https://healthterminologies.gov.au/fhir/ValueSet/common-languages-australia-2; other codes may be used where these codes are not suitable
Type | CodeableConcept
Must Support | true
Requirements | Knowing which language a practitioner speaks can help in facilitating communication with patients.
Comments | The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))