eHealth Infrastructure
3.2.0 - release

This page is part of the FUT Infrastructure (v3.2.0: 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-message - Detailed Descriptions

Active as of 2024-09-02

Definitions for the ehealth-message resource profile.

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

0. Communication
Invariantsnemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 (medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160)
note-invariant: Category note invariant (category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()))
notification-invariant: Category notification invariant (category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not()))
message-invariant: Category message invariant (category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() )))
advice-invariant: Category advice invariant (category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not()))
2. Communication.extension
Control1..?
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
    Control0..1
    TypeExtension(Episode of care) (Extension Type: Reference(EpisodeOfCare))
    6. Communication.extension:recipientCareTeam
    Slice NamerecipientCareTeam
    Control0..1
    TypeExtension(Recipient careteam) (Extension Type: Reference(ehealth-careteam)referenced)
    8. Communication.extension:senderCareTeam
    Slice NamesenderCareTeam
    Control0..1
    TypeExtension(Sender careteam) (Extension Type: Reference(ehealth-careteam)referenced)
    10. Communication.extension:restrictionCategory
    Slice NamerestrictionCategory
    Control0..*
    TypeExtension(Restriction category) (Extension Type: CodeableConcept)
    12. Communication.extension:threadId
    Slice NamethreadId
    Control0..1
    TypeExtension(Thread id) (Extension Type: string)
    14. Communication.extension:period
    Slice Nameperiod
    Control0..*
    TypeExtension(Period) (Extension Type: Period)
    16. Communication.extension:administrativeStatus
    Slice NameadministrativeStatus
    Control1..1
    TypeExtension(Administrative status) (Extension Type: Coding)
    18. Communication.extension:title
    Slice Nametitle
    Control0..1
    TypeExtension(Title) (Extension Type: string)
    20. Communication.extension:priority
    Slice Namepriority
    Control0..1
    TypeExtension(Priority) (Extension Type: code)
    22. Communication.extension:groupId
    Slice NamegroupId
    Control0..1
    TypeExtension(Group id) (Extension Type: string)
    24. Communication.extension:onBehalfOf
    Slice NameonBehalfOf
    Control0..1
    TypeExtension(On behalf of) (Extension Type: Reference(ehealth-careteam)referenced)
    Must Supporttrue
    26. Communication.partOf
    TypeReference(CarePlan)referenced
    28. Communication.category
    Control1..?
    SlicingThis element introduces a set of slices on Communication.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ coding.system
    • 30. Communication.category:DkTmCategory
      Slice NameDkTmCategory
      Control1..1
      32. Communication.category:DkTmCategory.coding
      34. Communication.category:DkTmCategory.coding.system
      Control1..?
      Pattern Valuehttp://ehealth.sundhed.dk/cs/message-category
      36. Communication.category:DkTmCategory.coding.code
      BindingThe codes SHALL be taken from MessageCategory
      (required to http://ehealth.sundhed.dk/vs/message-category)
      38. Communication.medium
      SlicingThis element introduces a set of slices on Communication.medium. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ coding.system
      • 40. Communication.medium:DkTmMedium
        Slice NameDkTmMedium
        Control0..1
        42. Communication.medium:DkTmMedium.coding
        44. Communication.medium:DkTmMedium.coding.system
        Control1..?
        Pattern Valuehttp://ehealth.sundhed.dk/cs/message-medium
        46. Communication.medium:DkTmMedium.coding.code
        BindingThe codes SHALL be taken from MessageMedium
        (required to http://ehealth.sundhed.dk/vs/message-medium)
        48. Communication.recipient
        Control0..1
        TypeReference(Patient, Practitioner)referenced
        50. Communication.sender
        TypeReference(Device, Patient, Practitioner)referenced, contained
        52. Communication.reasonCode
        BindingThe codes SHALL be taken from eHealth Message Reason Code
        (required to http://ehealth.sundhed.dk/vs/message-reasonCode)
        54. Communication.reasonReference
        TypeReference(Condition, Observation)referenced
        56. Communication.payload
        Control0..1
        58. 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 Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 60. 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
          62. Communication.note
          64. Communication.note.author[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          SlicingThis element introduces a set of slices on Communication.note.author[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 66. Communication.note.author[x]:authorReference
            Slice NameauthorReference
            Control0..1
            TypeReference(ehealth-practitioner, ehealth-patient, ehealth-relatedperson)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            68. Communication.note.author[x]:authorString
            Slice NameauthorString
            Control0..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())
            nemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 (medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160)
            note-invariant: Category note invariant (category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()))
            notification-invariant: Category notification invariant (category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not()))
            message-invariant: Category message invariant (category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() )))
            advice-invariant: Category advice invariant (category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not()))
            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.

            Control10..*
            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
              Control0..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..1
              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..1
              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
              Control0..*
              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.extension:threadId
              Slice NamethreadId
              Definition

              A logical id identifying a set of messages, which are grouped in a thread. Can be supplied by the client, eg. as a UUID

              ShortThread id
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Thread id) (Extension Type: string)
              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())
              16. Communication.extension:period
              Slice Nameperiod
              Definition

              Specifies the temporal validity of an ehealth/message instance. Contains a period, eg. specifying temporal validity

              ShortSpecifies the temporal validity of an ehealth/message instance
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(Period) (Extension Type: Period)
              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())
              18. Communication.extension:administrativeStatus
              Slice NameadministrativeStatus
              Definition

              The administrative status of how a message recipient has handled a message

              ShortThe administrative status of how a message recipient has handled a message
              Control1..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Administrative status) (Extension Type: Coding)
              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())
              20. Communication.extension:title
              Slice Nametitle
              Definition

              The title of the message

              ShortMessage title
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Title) (Extension Type: string)
              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())
              22. Communication.extension:priority
              Slice Namepriority
              Definition

              The priority of a message

              ShortThe priority of a message
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Priority) (Extension Type: code)
              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())
              24. Communication.extension:groupId
              Slice NamegroupId
              Definition

              A logical id identifying a set of messages, which have the same recipient (considered a 'group message'). Must be supplied by the client, eg. as a UUID

              ShortLogical id identifying a set of messages with the same recipient
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Group id) (Extension Type: string)
              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())
              26. Communication.extension:onBehalfOf
              Slice NameonBehalfOf
              Definition

              On behalf of

              ShortOn behalf of
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(On behalf of) (Extension Type: Reference(ehealth-careteam)referenced)
              Is Modifierfalse
              Must Supporttrue
              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())
              28. 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())
              30. Communication.partOf
              Definition

              Part of this action.

              ShortPart of this action
              Control0..*
              TypeReference(CarePlan, Resource)referenced
              Is Modifierfalse
              Summarytrue
              Alternate Namescontainer
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. 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()))
              34. 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..*
              BindingFor example codes, see CommunicationCategoryhttp://hl7.org/fhir/ValueSet/communication-category
              (example to http://hl7.org/fhir/ValueSet/communication-category)

              Codes for general categories of communications such as alerts, instructions, etc.

              TypeCodeableConcept
              Is Modifierfalse
              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.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ coding.system
              • 36. Communication.category:DkTmCategory
                Slice NameDkTmCategory
                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..1*
                BindingFor example codes, see CommunicationCategoryhttp://hl7.org/fhir/ValueSet/communication-category
                (example to http://hl7.org/fhir/ValueSet/communication-category)

                Codes for general categories of communications such as alerts, instructions, etc.

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

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

                ShortA channel of communication
                Control0..*
                BindingFor example codes, see ParticipationModehttp://terminology.hl7.org/ValueSet/v3-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()))
                SlicingThis element introduces a set of slices on Communication.medium. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ coding.system
                • 40. Communication.medium:DkTmMedium
                  Slice NameDkTmMedium
                  Definition

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

                  ShortA channel of communication
                  Control0..1*
                  BindingFor example codes, see ParticipationModehttp://terminology.hl7.org/ValueSet/v3-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()))
                  42. 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..1*
                  TypeReference(Patient, Practitioner, Device, Organization, 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()))
                  44. 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(Device, Patient, Practitioner, Organization, PractitionerRole, RelatedPerson, HealthcareService)referenced, contained
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. Communication.reasonCode
                  Definition

                  The reason or justification for the communication.

                  ShortIndication for message
                  Comments

                  Textual reasons can be captured using reasonCode.text.

                  Control0..*
                  BindingThe codes SHALL be taken from For example codes, see eHealth Message Reason Codehttp://hl7.org/fhir/ValueSet/clinical-findings
                  (required to http://ehealth.sundhed.dk/vs/message-reasonCode)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  48. Communication.reasonReference
                  Definition

                  Indicates another resource whose existence justifies this communication.

                  ShortWhy was communication done?
                  Control0..*
                  TypeReference(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()))
                  50. Communication.payload
                  Definition

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

                  ShortMessage payload
                  Control0..1*
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. 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())
                  54. Communication.payload.content[x]
                  Definition

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

                  ShortMessage part content
                  Control1..1
                  Typestring, Reference(Resource), Attachment
                  [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
                  • 56. 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, Reference(Resource), Attachment
                    [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()))

                    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())
                    nemsms-invariant: If communication resource is a NemSMS payload cannot exceed 160 (medium.coding.where(code = 'nemsms').exists() implies payload.contentString.length() <= 160)
                    note-invariant: Category note invariant (category.coding.code = 'note' implies (sender.reference = recipient.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()))
                    notification-invariant: Category notification invariant (category.coding.code = 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not()))
                    message-invariant: Category message invariant (category.coding.code = 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').valueReference.exists() )))
                    advice-invariant: Category advice invariant (category.coding.code = 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').valueReference.exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not()))
                    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
                    Control1..*
                    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
                      Control0..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..1
                      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..1
                      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
                      Control0..*
                      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.extension:threadId
                      Slice NamethreadId
                      Definition

                      A logical id identifying a set of messages, which are grouped in a thread. Can be supplied by the client, eg. as a UUID

                      ShortThread id
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Thread id) (Extension Type: string)
                      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())
                      26. Communication.extension:period
                      Slice Nameperiod
                      Definition

                      Specifies the temporal validity of an ehealth/message instance. Contains a period, eg. specifying temporal validity

                      ShortSpecifies the temporal validity of an ehealth/message instance
                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Period) (Extension Type: Period)
                      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())
                      28. Communication.extension:administrativeStatus
                      Slice NameadministrativeStatus
                      Definition

                      The administrative status of how a message recipient has handled a message

                      ShortThe administrative status of how a message recipient has handled a message
                      Control1..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Administrative status) (Extension Type: Coding)
                      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())
                      30. Communication.extension:title
                      Slice Nametitle
                      Definition

                      The title of the message

                      ShortMessage title
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Title) (Extension Type: string)
                      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())
                      32. Communication.extension:priority
                      Slice Namepriority
                      Definition

                      The priority of a message

                      ShortThe priority of a message
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Priority) (Extension Type: code)
                      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())
                      34. Communication.extension:groupId
                      Slice NamegroupId
                      Definition

                      A logical id identifying a set of messages, which have the same recipient (considered a 'group message'). Must be supplied by the client, eg. as a UUID

                      ShortLogical id identifying a set of messages with the same recipient
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Group id) (Extension Type: string)
                      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())
                      36. Communication.extension:onBehalfOf
                      Slice NameonBehalfOf
                      Definition

                      On behalf of

                      ShortOn behalf of
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(On behalf of) (Extension Type: Reference(ehealth-careteam)referenced)
                      Is Modifierfalse
                      Must Supporttrue
                      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())
                      38. 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())
                      40. 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()))
                      42. 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()))
                      44. 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()))
                      46. 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)
                      Is Modifierfalse
                      Summarytrue
                      Alternate Namesfulfills
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      48. Communication.partOf
                      Definition

                      Part of this action.

                      ShortPart of this action
                      Control0..*
                      TypeReference(CarePlan)referenced
                      Is Modifierfalse
                      Summarytrue
                      Alternate Namescontainer
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      50. 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()))
                      52. 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()))
                      54. 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()))
                      56. 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..*
                      BindingFor example codes, see CommunicationCategory
                      (example to http://hl7.org/fhir/ValueSet/communication-category)

                      Codes for general categories of communications such as alerts, instructions, etc.

                      TypeCodeableConcept
                      Is Modifierfalse
                      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.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ coding.system
                      • 58. Communication.category:DkTmCategory
                        Slice NameDkTmCategory
                        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..1
                        BindingFor example codes, see CommunicationCategory
                        (example to http://hl7.org/fhir/ValueSet/communication-category)

                        Codes for general categories of communications such as alerts, instructions, etc.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        60. Communication.category:DkTmCategory.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
                        62. Communication.category:DkTmCategory.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())
                        SlicingThis element introduces a set of slices on Communication.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 64. Communication.category:DkTmCategory.coding
                          Definition

                          A reference to a code defined by a terminology system.

                          ShortCode defined by a terminology system
                          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 labeled as UserSelected = true.

                          Control0..*
                          TypeCoding
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Allows for alternative encodings within a code system, and translations to other code systems.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          66. Communication.category:DkTmCategory.coding.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
                          68. Communication.category:DkTmCategory.coding.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())
                          SlicingThis element introduces a set of slices on Communication.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 70. Communication.category:DkTmCategory.coding.system
                            Definition

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

                            ShortIdentity of the terminology system
                            Comments

                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

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

                            Pattern Valuehttp://ehealth.sundhed.dk/cs/message-category
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            72. Communication.category:DkTmCategory.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.

                            ShortVersion of the system - if relevant
                            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.

                            NoteThis is a business version Id, not a resource version Id (see discussion)
                            Control0..1
                            Typestring
                            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()))
                            74. Communication.category:DkTmCategory.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).

                            ShortSymbol in syntax defined by the system
                            Control0..1
                            BindingThe codes SHALL be taken from MessageCategory
                            (required to http://ehealth.sundhed.dk/vs/message-category)
                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to refer to a particular code in the system.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            76. Communication.category:DkTmCategory.coding.display
                            Definition

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

                            ShortRepresentation defined by the system
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            78. Communication.category:DkTmCategory.coding.userSelected
                            Definition

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

                            ShortIf this coding was chosen directly by the user
                            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.

                            Control0..1
                            Typeboolean
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            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.

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

                            ShortPlain text representation of the concept
                            Comments

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

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            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.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            82. 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()))
                            84. 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()))
                            SlicingThis element introduces a set of slices on Communication.medium. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ coding.system
                            • 86. Communication.medium:DkTmMedium
                              Slice NameDkTmMedium
                              Definition

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

                              ShortA channel of communication
                              Control0..1
                              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()))
                              88. Communication.medium:DkTmMedium.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
                              90. Communication.medium:DkTmMedium.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())
                              SlicingThis element introduces a set of slices on Communication.medium.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 92. Communication.medium:DkTmMedium.coding
                                Definition

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                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 labeled as UserSelected = true.

                                Control0..*
                                TypeCoding
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Allows for alternative encodings within a code system, and translations to other code systems.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                94. Communication.medium:DkTmMedium.coding.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
                                96. Communication.medium:DkTmMedium.coding.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())
                                SlicingThis element introduces a set of slices on Communication.medium.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 98. Communication.medium:DkTmMedium.coding.system
                                  Definition

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

                                  ShortIdentity of the terminology system
                                  Comments

                                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                  Control1..1
                                  Typeuri
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

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

                                  Pattern Valuehttp://ehealth.sundhed.dk/cs/message-medium
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  100. Communication.medium:DkTmMedium.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.

                                  ShortVersion of the system - if relevant
                                  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.

                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                  Control0..1
                                  Typestring
                                  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()))
                                  102. Communication.medium:DkTmMedium.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).

                                  ShortSymbol in syntax defined by the system
                                  Control0..1
                                  BindingThe codes SHALL be taken from MessageMedium
                                  (required to http://ehealth.sundhed.dk/vs/message-medium)
                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Need to refer to a particular code in the system.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  104. Communication.medium:DkTmMedium.coding.display
                                  Definition

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

                                  ShortRepresentation defined by the system
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

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

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  106. Communication.medium:DkTmMedium.coding.userSelected
                                  Definition

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

                                  ShortIf this coding was chosen directly by the user
                                  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.

                                  Control0..1
                                  Typeboolean
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  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.

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

                                  ShortPlain text representation of the concept
                                  Comments

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

                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  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.

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

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

                                  ShortFocus of message
                                  Control0..1
                                  TypeReference(Patient, Group)
                                  Is Modifierfalse
                                  Summarytrue
                                  Alternate Namespatient
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  112. 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()))
                                  114. 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()))
                                  116. 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()))
                                  118. 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()))
                                  120. 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()))
                                  122. 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..1
                                  TypeReference(Patient, Practitioner)referenced
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  124. 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(Device, Patient, Practitioner)referenced, contained
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  126. Communication.reasonCode
                                  Definition

                                  The reason or justification for the communication.

                                  ShortIndication for message
                                  Comments

                                  Textual reasons can be captured using reasonCode.text.

                                  Control0..*
                                  BindingThe codes SHALL be taken from eHealth Message Reason Code
                                  (required to http://ehealth.sundhed.dk/vs/message-reasonCode)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  128. Communication.reasonReference
                                  Definition

                                  Indicates another resource whose existence justifies this communication.

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

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

                                  ShortMessage payload
                                  Control0..1
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  132. 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
                                  134. 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())
                                  136. 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())
                                  138. 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
                                  • 140. 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()))
                                    142. 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()))
                                    144. Communication.note.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
                                    146. Communication.note.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())
                                    SlicingThis element introduces a set of slices on Communication.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 148. Communication.note.author[x]
                                      Definition

                                      The individual responsible for making the annotation.

                                      ShortIndividual responsible for the annotation
                                      Comments

                                      Organization is used when there's no need for specific attribution as to who made the comment.

                                      Control0..1
                                      TypeChoice of: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                      [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
                                      Summarytrue
                                      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.note.author[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                      • type @ $this
                                      • 150. Communication.note.author[x]:authorReference
                                        Slice NameauthorReference
                                        Definition

                                        The individual responsible for making the annotation.

                                        ShortIndividual responsible for the annotation
                                        Comments

                                        Organization is used when there's no need for specific attribution as to who made the comment.

                                        Control0..1
                                        TypeReference(ehealth-practitioner, ehealth-patient, ehealth-relatedperson)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        152. Communication.note.author[x]:authorString
                                        Slice NameauthorString
                                        Definition

                                        The individual responsible for making the annotation.

                                        ShortIndividual responsible for the annotation
                                        Comments

                                        Organization is used when there's no need for specific attribution as to who made the comment.

                                        Control0..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
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        154. Communication.note.time
                                        Definition

                                        Indicates when this particular annotation was made.

                                        ShortWhen the annotation was made
                                        Control0..1
                                        TypedateTime
                                        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()))
                                        156. Communication.note.text
                                        Definition

                                        The text of the annotation in markdown format.

                                        ShortThe annotation - text content (as markdown)
                                        Control1..1
                                        Typemarkdown
                                        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()))