eHealth Infrastructure
3.1.0 - release

This page is part of the FUT Infrastructure (v3.1.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: ehealth-communication - Detailed Descriptions

Active as of 2024-07-01

Definitions for the ehealth-communication resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Communication
2. Communication.extension
Control2..?
SlicingThis element introduces a set of slices on Communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Communication.extension:episodeOfCare
    Slice NameepisodeOfCare
    Control1..1
    TypeExtension(Episode of care) (Extension Type: Reference(EpisodeOfCare))
    6. Communication.extension:recipientCareTeam
    Slice NamerecipientCareTeam
    Control0..*
    TypeExtension(Recipient careteam) (Extension Type: Reference(ehealth-careteam)referenced)
    8. Communication.extension:senderCareTeam
    Slice NamesenderCareTeam
    Control0..*
    TypeExtension(Sender careteam) (Extension Type: Reference(ehealth-careteam)referenced)
    10. Communication.extension:restrictionCategory
    Slice NamerestrictionCategory
    Control1..*
    TypeExtension(Restriction category) (Extension Type: CodeableConcept)
    12. Communication.basedOn
    TypeReference(Resource)referenced
    14. Communication.partOf
    TypeReference(Resource)referenced
    16. Communication.category
    Control1..?
    BindingThe codes SHALL be taken from Communication Category
    (required to http://ehealth.sundhed.dk/vs/communication-category)
    18. Communication.subject
    Control1..?
    TypeReference(ehealth-patient)referenced
    20. Communication.recipient
    TypeReference(ehealth-device, ehealth-patient, ehealth-practitioner, ehealth-relatedperson)referenced
    22. Communication.sender
    TypeReference(ehealth-device, ehealth-patient, ehealth-practitioner, ehealth-relatedperson)referenced
    24. Communication.reasonReference
    TypeReference(ehealth-condition, ehealth-observation)referenced
    26. Communication.payload
    28. Communication.payload.content[x]
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on Communication.payload.content[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 30. Communication.payload.content[x]:contentString
      Slice NamecontentString
      Control1..1
      Typestring
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

      Guidance on how to interpret the contents of this table can be found here

      0. 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 a reportable condition.

      ShortA record of information transmitted from a sender to a receiver
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: 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())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Communication.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.

      ShortA set of rules under which this content was created
      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.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. Communication.extension
      Definition

      An Extension


      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.

      ShortExtensionAdditional content defined by implementations
      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.

      Control20..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-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())
      SlicingThis element introduces a set of slices on Communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Communication.extension:episodeOfCare
        Slice NameepisodeOfCare
        Definition

        Identifies the episode(s) of care that this resource is relevant to. Establishes the EpisodeOfCare as a 'grouper' of resources that are relevant to that episode.

        ShortAssociated Encounter episode of care
        Control1..1
        TypeExtension(Episode of care) (Extension Type: Reference(EpisodeOfCare))
        Is Modifierfalse
        Invariantsele-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())
        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())
        8. Communication.extension:recipientCareTeam
        Slice NamerecipientCareTeam
        Definition

        CareTeam that is a recipient of a Communication

        ShortCareTeam message recipient
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Recipient careteam) (Extension Type: Reference(ehealth-careteam)referenced)
        Is Modifierfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        10. Communication.extension:senderCareTeam
        Slice NamesenderCareTeam
        Definition

        CareTeam that is a sender of a Communication

        ShortCareTeam message sender
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Sender careteam) (Extension Type: Reference(ehealth-careteam)referenced)
        Is Modifierfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        12. Communication.extension:restrictionCategory
        Slice NamerestrictionCategory
        Definition

        The resource is intended for certain category of workflow/responsibility only

        ShortRestriction category
        Control1..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Restriction category) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        14. Communication.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).

        ShortExtensions that cannot be ignored
        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        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 Namesextensions, user content
        Invariantsele-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())
        16. Communication.basedOn
        Definition

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

        ShortRequest fulfilled by this communication
        Comments

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

        Control0..*
        TypeReference(Resource)referenced
        Is Modifierfalse
        Summarytrue
        Alternate Namesfulfills
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Communication.partOf
        Definition

        Part of this action.

        ShortPart of this action
        Control0..*
        TypeReference(Resource)referenced
        Is Modifierfalse
        Summarytrue
        Alternate Namescontainer
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. Communication.status
        Definition

        The status of the transmission.

        Shortpreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
        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.

        Control1..1
        BindingThe codes SHALL be taken from EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

        The status of the communication.

        Typecode
        Is Modifiertrue because 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
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Communication.category
        Definition

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

        ShortMessage category
        Comments

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

        Control10..*
        BindingThe codes SHALL be taken from For example codes, see Communication Categoryhttp://hl7.org/fhir/ValueSet/communication-category
        (required to http://ehealth.sundhed.dk/vs/communication-category)
        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Communication.subject
        Definition

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

        ShortFocus of message
        Control10..1
        TypeReference(ehealth-patient, Patient, Group)referenced
        Is Modifierfalse
        Summarytrue
        Alternate Namespatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Communication.recipient
        Definition

        The entity (e.g. person, organization, clinical information system, care team or device) which was 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).

        ShortMessage recipient
        Control0..*
        TypeReference(ehealth-device, ehealth-patient, ehealth-practitioner, ehealth-relatedperson, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Group, CareTeam, HealthcareService)referenced
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Communication.sender
        Definition

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

        ShortMessage sender
        Control0..1
        TypeReference(ehealth-device, ehealth-patient, ehealth-practitioner, ehealth-relatedperson, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService)referenced
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Communication.reasonReference
        Definition

        Indicates another resource whose existence justifies this communication.

        ShortWhy was communication done?
        Control0..*
        TypeReference(ehealth-condition, ehealth-observation, Condition, Observation, DiagnosticReport, DocumentReference)referenced
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

        Guidance on how to interpret the contents of this table can be found here

        0. 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 a reportable condition.

        ShortA record of information transmitted from a sender to a receiver
        Control0..*
        Is Modifierfalse
        Summaryfalse
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
        dom-4: 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())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        dom-6: A resource should have narrative for robust management (text.`div`.exists())
        2. Communication.id
        Definition

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

        ShortLogical id of this artifact
        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.

        Control0..1
        Typeid
        Is Modifierfalse
        Summarytrue
        4. Communication.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.

        ShortMetadata about the resource
        Control0..1
        TypeMeta
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. Communication.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.

        ShortA set of rules under which this content was created
        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.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. Communication.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        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).

        Control0..1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. Communication.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.

        ShortText summary of the resource, for human interpretation
        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.

        Control0..1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. Communication.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.

        ShortContained, inline 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.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        14. Communication.extension
        Definition

        An Extension

        ShortExtension
        Control2..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Invariantsele-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())
        SlicingThis element introduces a set of slices on Communication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. Communication.extension:episodeOfCare
          Slice NameepisodeOfCare
          Definition

          Identifies the episode(s) of care that this resource is relevant to. Establishes the EpisodeOfCare as a 'grouper' of resources that are relevant to that episode.

          ShortAssociated Encounter episode of care
          Control1..1
          TypeExtension(Episode of care) (Extension Type: Reference(EpisodeOfCare))
          Is Modifierfalse
          Invariantsele-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())
          18. Communication.extension:recipientCareTeam
          Slice NamerecipientCareTeam
          Definition

          CareTeam that is a recipient of a Communication

          ShortCareTeam message recipient
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Recipient careteam) (Extension Type: Reference(ehealth-careteam)referenced)
          Is Modifierfalse
          Invariantsele-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())
          20. Communication.extension:senderCareTeam
          Slice NamesenderCareTeam
          Definition

          CareTeam that is a sender of a Communication

          ShortCareTeam message sender
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Sender careteam) (Extension Type: Reference(ehealth-careteam)referenced)
          Is Modifierfalse
          Invariantsele-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())
          22. Communication.extension:restrictionCategory
          Slice NamerestrictionCategory
          Definition

          The resource is intended for certain category of workflow/responsibility only

          ShortRestriction category
          Control1..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Restriction category) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Invariantsele-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. Communication.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).

          ShortExtensions that cannot be ignored
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          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 Namesextensions, user content
          Invariantsele-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())
          26. 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.

          ShortUnique identifier
          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.

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

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

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. 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.

          ShortInstantiates FHIR protocol or definition
          Control0..*
          Typecanonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire)
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. 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.

          ShortInstantiates external protocol or definition
          Comments

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

          Control0..*
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Communication.basedOn
          Definition

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

          ShortRequest fulfilled by this communication
          Comments

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

          Control0..*
          TypeReference(Resource)referenced
          Is Modifierfalse
          Summarytrue
          Alternate Namesfulfills
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Communication.partOf
          Definition

          Part of this action.

          ShortPart of this action
          Control0..*
          TypeReference(Resource)referenced
          Is Modifierfalse
          Summarytrue
          Alternate Namescontainer
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Communication.inResponseTo
          Definition

          Prior communication that this communication is in response to.

          ShortReply to
          Control0..*
          TypeReference(Communication)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Communication.status
          Definition

          The status of the transmission.

          Shortpreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
          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.

          Control1..1
          BindingThe codes SHALL be taken from EventStatus
          (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

          The status of the communication.

          Typecode
          Is Modifiertrue because 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
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Communication.statusReason
          Definition

          Captures the reason for the current state of the Communication.

          ShortReason for current status
          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.

          Control0..1
          BindingFor example codes, see CommunicationNotDoneReason
          (example to http://hl7.org/fhir/ValueSet/communication-not-done-reason)

          Codes for the reason why a communication did not happen.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Alternate NamesSuspended Reason, Cancelled Reason
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Communication.category
          Definition

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

          ShortMessage category
          Comments

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

          Control1..*
          BindingThe codes SHALL be taken from Communication Category
          (required to http://ehealth.sundhed.dk/vs/communication-category)
          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Communication.priority
          Definition

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

          Shortroutine | urgent | asap | stat
          Comments

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

          Control0..1
          BindingThe codes SHALL be taken from RequestPriority
          (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

          Codes indicating the relative importance of a communication.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Meaning if MissingIf missing, this communication should be treated with normal priority
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Communication.medium
          Definition

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

          ShortA channel of communication
          Control0..*
          BindingFor example codes, see ParticipationMode
          (example to http://terminology.hl7.org/ValueSet/v3-ParticipationMode)

          Codes for communication mediums such as phone, fax, email, in person, etc.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. Communication.subject
          Definition

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

          ShortFocus of message
          Control1..1
          TypeReference(ehealth-patient)referenced
          Is Modifierfalse
          Summarytrue
          Alternate Namespatient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. Communication.topic
          Definition

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

          ShortDescription of the purpose/content
          Comments

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

          Control0..1
          BindingFor example codes, see CommunicationTopic
          (example to http://hl7.org/fhir/ValueSet/communication-topic)

          Codes describing the purpose or content of the communication.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. Communication.about
          Definition

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

          ShortResources that pertain to this communication
          Comments

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

          Control0..*
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. Communication.encounter
          Definition

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

          ShortEncounter created as part of
          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.

          Control0..1
          TypeReference(Encounter)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. Communication.sent
          Definition

          The time when this communication was sent.

          ShortWhen sent
          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          58. Communication.received
          Definition

          The time when this communication arrived at the destination.

          ShortWhen received
          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Communication.recipient
          Definition

          The entity (e.g. person, organization, clinical information system, care team or device) which was 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).

          ShortMessage recipient
          Control0..*
          TypeReference(ehealth-device, ehealth-patient, ehealth-practitioner, ehealth-relatedperson)referenced
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. Communication.sender
          Definition

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

          ShortMessage sender
          Control0..1
          TypeReference(ehealth-device, ehealth-patient, ehealth-practitioner, ehealth-relatedperson)referenced
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. Communication.reasonCode
          Definition

          The reason or justification for the communication.

          ShortIndication for message
          Comments

          Textual reasons can be captured using reasonCode.text.

          Control0..*
          BindingFor example codes, see SNOMEDCTClinicalFindings
          (example to http://hl7.org/fhir/ValueSet/clinical-findings)

          Codes for describing reasons for the occurrence of a communication.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. Communication.reasonReference
          Definition

          Indicates another resource whose existence justifies this communication.

          ShortWhy was communication done?
          Control0..*
          TypeReference(ehealth-condition, ehealth-observation)referenced
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. Communication.payload
          Definition

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

          ShortMessage payload
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. Communication.payload.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          72. Communication.payload.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. 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.

          ShortAdditional content defined by implementations
          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-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())
          74. Communication.payload.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).

          ShortExtensions that cannot be ignored even if unrecognized
          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          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 Namesextensions, user content, modifiers
          Invariantsele-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())
          76. Communication.payload.content[x]
          Definition

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

          ShortMessage part content
          Control1..1
          Typestring
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Communication.payload.content[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 78. Communication.payload.content[x]:contentString
            Slice NamecontentString
            Definition

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

            ShortMessage part content
            Control1..1
            Typestring
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. Communication.note
            Definition

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

            ShortComments made about the communication
            Control0..*
            TypeAnnotation
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))