Shared Health Specification and Guide Version 5.0

 

Definitions for the profile-practitioner-locum Profile.

1. Practitioner
Definition

A person who is directly or indirectly involved in the provisioning of healthcare.

Control0..*
Must Supporttrue
Comments

For locum Practitioners, only one identifier - the license number - can be provided as locums are not registered in the Provider Registry.

Max Length0
2. Practitioner.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control1..1
Typeid
Must Supporttrue
Comments

Usage Note: This will usually be a GUID and is assigned by the sending application.

Max Length0
3. Practitioner.meta
Definition

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.

Control0..1
TypeMeta
Max Length0
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.

Control0..1
Typeuri
Is Modifiertrue
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 as much as possible.

Max Length0
5. Practitioner.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHALL be taken from http://tools.ietf.org/html/bcp47 A human language.
Typecode
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).

Max Length0
6. Practitioner.text
Definition

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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

Max Length0
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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

Max Length0
8. Practitioner.extension
Definition

An Extension

Control0..*
TypeExtension
Must Supporttrue
Max Length0
SlicingThis element introduces a set of slices on Practitioner.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. Practitioner.extension:locumIndicator
SliceNamelocumIndicator
Definition

An Extension

Control1..1
TypeExtension(Practitioner Locum Indicator) (Extension Type: boolean)
Must Supporttrue
Max Length0
10. 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. 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user 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.

Max Length0
11. Practitioner.identifier
Definition

A technical identifier - identifies some entity uniquely and unambiguously.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier(Shared Health Person Identifier)
Must Supporttrue
Requirements

Often, specific identities are assigned for the agent.

Comments

Only the license identifier is expected - denoted by an Identifier.type.coding.code of 'LN'. Conformance Rule: The Provider Registry identifier SHALL be sent if the practioner is the initiating practitioner for the tasks in a message. The Provider Registry identifier SHOULD be sent if known if the practitioner is being sent for other purposes (e.g. the prescriber of a prescription for which a renewal is being sought).

When transmitting the provider registry identifier, the system shall be 'http://sharedhealth.exchange/fhir/NamingSystem/registry-id-practitioner' and the value shall be the provider-registry assigned id (and SHALL be the same value as in Practitioner.id). The Identifier.type shall have a coding from the 'http://hl7.org/fhir/v2/0203' system of 'LR'.

When transmitting the provider license number (always mandatory), the Identifier.type shall have a coding from the 'http://hl7.org/fhir/v2/0203' system of 'LN'. The system will be a standard OID (refer to the implementation guide) for the specific license type expressed as a urn (e.g. urn:oid:1.2.3.4). A list of OIDs for different license types can be found in the Vendor Implementation Guide. In a future version of this specification, we may be migrating from OIDs to more readable URL’s. You can plan for this in your design. Conformance Rule: The second identifier provided will be the licence ID of the Prescriber. The assigning authority OID will be determined based on the licencing body; a list of which is found within the Vendor Implementation guide.

Max Length0
SlicingThis element introduces a set of slices on Practitioner.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ type.coding.system
  • ,
  • value @ type.coding.code
12. Practitioner.identifier:license
SliceNamelicense
Definition

An identifier that applies to this person in this role.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..10
TypeIdentifier
Must Supporttrue
Requirements

Often, specific identities are assigned for the agent.

Comments

Conformance Rule: Only a single licence number can be submitted. For Prescriber's with multiple licence numbers, the licence number must be the one that the Prescriber is acting under the authority of when Prescribing.

Max Length0
13. Practitioner.identifier:license.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
14. Practitioner.identifier:license.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user 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.

Max Length0
15. Practitioner.identifier:license.use
Definition

The purpose of this identifier.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known .
Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Max Length0
16. Practitioner.identifier:license.type
Definition

A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.

Control1..1
BindingThe codes SHALL be taken from IdentifierType (20210501); other codes may be used where these codes are not suitable
TypeCodeableConcept(Shared Health CodeableConcept Code)
Must Supporttrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

-

Max Length0
17. Practitioner.identifier:license.type.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
18. Practitioner.identifier:license.type.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user 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.

Max Length0
19. Practitioner.identifier:license.type.coding
Definition

A reference to a code defined by a terminology system.

Control1..*
TypeCoding
Must Supporttrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

Max Length0
20. Practitioner.identifier:license.type.coding.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
21. Practitioner.identifier:license.type.coding.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user 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.

Max Length0
22. Practitioner.identifier:license.type.coding.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control1..1
Typeuri
Must Supporttrue
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Fixed value: http://hl7.org/fhir/v2/0203

Max Length0
Fixed Valuehttp://hl7.org/fhir/v2/0203
23. Practitioner.identifier:license.type.coding.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Max Length0
24. Practitioner.identifier:license.type.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control1..1
Typecode
Must Supporttrue
Requirements

Need to refer to a particular code in the system.

Comments

Fixed value: LN

Max Length0
Fixed ValueLN
25. Practitioner.identifier:license.type.coding.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Must Supporttrue
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Max Length0
26. Practitioner.identifier:license.type.coding.userSelected
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Max Length0
27. Practitioner.identifier:license.type.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

Max Length0
28. Practitioner.identifier:license.system
Definition

Establishes the namespace in which set of possible id values is unique.

Control1..1
BindingThe codes SHALL be taken from SharedPractitionerIdentifierType
Typeuri
Must Supporttrue
Requirements

There are many sequences of identifiers. To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.

Comments

The jurisdictional licensing body (e.g. College of Physicians and Surgeons) that issued the practitioner’s license, chosen from terminology binding (this will be an OID expressed as a URI).

Max Length0
Example
General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
29. Practitioner.identifier:license.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control1..1
Typestring
Must Supporttrue
Comments

This is the Practitioner license number

Max Length0
Example
General:123456
30. Practitioner.identifier:license.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
Max Length0
31. Practitioner.identifier:license.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Max Length0
32. Practitioner.active
Definition

Whether this practitioner's record is in active use.

Control0..1
Typeboolean
Requirements

Need to be able to mark a practitioner record as not to be used because it was created in error.

Comments

Default is true. 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.

Max Length0
Default Valuetrue
33. Practitioner.name
Definition

A human's name with the ability to identify parts and usage.

Control1..1
TypeHumanName(Shared Health HumanName)
Must Supporttrue
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

Conformance Rule: Set use = Professional; Alias is optional.

Max Length0
34. Practitioner.telecom
Definition

This segment provide methods of contacting the practitioner. Only numbers that have authorized to be disclosed by the practitioner should be included. For example, most practitioners do not authorize the disclosure of their cell phone number to pharmacies.

Control0..*
TypeContactPoint(Shared Health ContactPoint)
Must Supporttrue
Requirements

Need to know how to reach a practitioner independent to any roles the practitioner may have.

Comments

-

Max Length0
InvariantsDefined on this element
cpt-2: A system is required if a value is provided. (: value.empty() or system.exists())
35. 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.

Control0..*
TypeAddress
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 PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

Max Length0
36. Practitioner.gender
Definition

Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

Control0..1
BindingThe codes SHALL be taken from AdministrativeGender The gender of a person used for administrative purposes.
Typecode
Requirements

Needed to address the person correctly.

Max Length0
37. Practitioner.birthDate
Definition

The date of birth for the practitioner.

Control0..1
Typedate
Requirements

Needed for identification.

Max Length0
38. Practitioner.photo
Definition

Image of the person.

Control0..*
TypeAttachment
Requirements

Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.

Max Length0
39. Practitioner.practitionerRole
Definition

The list of roles/organizations that the practitioner is associated with.

Control0..*
TypeBackboneElement
Comments

The address to be used for this PractitionerRole is in the referenced location (removing duplication across all the services provided at the location).

Max Length0
40. Practitioner.practitionerRole.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
41. Practitioner.practitionerRole.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user 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.

Max Length0
42. Practitioner.practitionerRole.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 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

Max Length0
43. Practitioner.practitionerRole.organization
Definition

The organization where the Practitioner performs the roles associated.

Control0..1
TypeReference(Organization)
Max Length0
44. Practitioner.practitionerRole.role
Definition

Roles which this practitioner is authorized to perform for the organization.

Control0..1
BindingFor example codes, see PractitionerRole The role a person plays representing an organization
TypeCodeableConcept
Requirements

Need to know what authority the practitioner has - what can they do?

Comments

A person may have more than one role. At least one role is required.

Max Length0
45. Practitioner.practitionerRole.specialty
Definition

Specific specialty of the practitioner.

Control0..*
BindingFor example codes, see PractitionerSpecialty Specific specialty associated with the agency
TypeCodeableConcept
Max Length0
46. Practitioner.practitionerRole.identifier
Definition

Business Identifiers that are specific to a role/location.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Some business identifiers are specific to a location and should be able to be associated.

Max Length0
47. Practitioner.practitionerRole.telecom
Definition

Contact details that are specific to the role/location/service.

Control0..*
TypeContactPoint
Requirements

Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these.

Max Length0
48. Practitioner.practitionerRole.period
Definition

The period during which the person is authorized to act as a practitioner in these role(s) for the organization.

Control0..1
TypePeriod
Requirements

Even after the agencies is revoked, the fact that it existed must still be recorded.

Max Length0
49. Practitioner.practitionerRole.location
Definition

The location(s) at which this practitioner provides care.

Control0..*
TypeReference(Location)
Max Length0
50. Practitioner.practitionerRole.healthcareService
Definition

The list of healthcare services that this worker provides for this role's Organization/Location(s).

Control0..*
TypeReference(HealthcareService)
Max Length0
51. Practitioner.qualification
Definition

Qualifications obtained by training and certification.

Control0..*
TypeBackboneElement
Max Length0
52. Practitioner.qualification.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
53. Practitioner.qualification.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user 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.

Max Length0
54. 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 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

Max Length0
55. Practitioner.qualification.identifier
Definition

An identifier that applies to this person's qualification in this role.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Often, specific identities are assigned for the qualification.

Max Length0
56. Practitioner.qualification.code
Definition

Coded representation of the qualification.

Control1..1
BindingFor example codes, see ANZSCO -- Australian and New Zealand Standard Classification of Occupations, 2013, Version 1.2 Specific qualification the practitioner has to provide a service
TypeCodeableConcept
Max Length0
57. Practitioner.qualification.period
Definition

Period during which the qualification is valid.

Control0..1
TypePeriod
Requirements

Qualifications are often for a limited period of time, and can be revoked.

Max Length0
58. Practitioner.qualification.issuer
Definition

Organization that regulates and issues the qualification.

Control0..1
TypeReference(Organization)
Max Length0
59. Practitioner.communication
Definition

A language the practitioner is able to use in patient communication.

Control0..*
BindingThe codes SHALL be taken from http://tools.ietf.org/html/bcp47 A human language.
TypeCodeableConcept
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 actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

Max Length0