Introduction

An ehealth-message defines written communication and comes in four flavours depending on the "category" of the message:

• Message: For sending user-generated messages from Patients and CareTeams (Practitioners) to Patients or CareTeams. Messages may not be sent between Patients or between Practitioners. When sending a message to a CareTeam, it is possible to narrow the recipient to be of a certain role. This is done by setting the "restriction-category" extension to a specific role value.
• Notification: Must regard an incident or event that has already occurred, where the sender must be of type Device, and the recipient must be a Patient or CareTeam. These are usually text-based, and may have a temporal validity attached (see "period" extension) to indicate at which point a notification is no longer valid. When sent, a notification may no longer be updated by the sender.
• Advise: Advise is much like notifications. They may also have a validity period, but they may only concern a future planned event, eg. a measurement or online meeting which is to take place. The sender must be of type Device, and the recipient must be a Patient or CareTeam
• Note: For personal notes (written by a Patient or Practitioner), which may be shared with a CareTeam. A personal note must be created with sender=recipient. In case a personal note wants to be shared with a CareTeam, the CareTeam must be referred by the recipientCareTeam extension, and the receiver deleted (both can take place in the same PATCH operation). A personal note may be updated by the sender, but not by the recipient.

An ehealth-message may refer related resources (eg. Device, CarePlan, Appointment etc) using the "about" field, no matter which category it is. Different instances of ehealth-message may be logically organized into "threads" by assigning the same thread-id in the provided extension. Similarly, they may be organized in a group (eg. group messages) by assigning the same group-id in that extension. The message subject may be provided in the title extension, and an optional priority may be provided in the ehealth-priority extension.

Remarks about status and administrative-status

The ehealth-message profile contains two status fields:

• status:
  • For notes (category='note') the status field has no restrictions or implications
  • For messages (category='message') the following status transitions rules are in effect:
    • A message is considered "not yet sent" when it has one of the following status and can freely transition from one to another: 'preparation', 'on-hold', 'not-done', 'entered-in-error'
    • A message is considered "being sent" when created or patched into status 'in-progress' and cannot be patched further or deleted by the sender
      • The server will automatically transition a message from 'in-progress' to 'completed' when it has been sent successfully (happens immediately for non-NemSMS mediums and is reflected in the returned resource)
      • The server will automatically transition a message from 'in-progress' to 'stopped' if it could not be sent (currently only happens if a NemSMS could not be sent)
    • The client can never create or patch a message into status 'completed' or 'stopped'
    • The sender cannot patch, only delete messages with status 'stopped'
    • The sender cannot patch or delete messages with status 'completed'
    • The recipient can patch /received and administrative-status on messages with status 'completed'
• administrative-status (extension): Makes it possible for the message recipient to indicate the state of a message. A message may hold an administrative status that defines the last action the recipient took on the message in question. At first, the message has administrative-status "activate". The recipient may mark the message as read by setting administrative-status "read". If the recipient considers the message a sort of "task", the message may also be updated with administrative-status "complete" when the task is done, or "reactivate" if the task was not complete anyway.

Fields with auto-assigned values

Some fields are filled in automatically on message creation, eg. if a sound default value makes sense. These fields are:

• Field "sent": If message state is set to "in-progress" on creation, then the "sent" field will be assigned current date/time.
• Extension "restriction-category": If not set by the caller, it will be set to value "None"
• Extension "thread-id": In case a thread-id is not set by the client, it will be generated server-side (random UUID) at message creation.

Search parameters

The following custom search parameters may be used when searching for ehealth-message instances:

• administrativeStatus: Specify the desired administrative status using system and code (eg. "http://ehealth.sundhed.dk/cs/administrative-status" and "read")
• careTeamRecipient: Specify an absolute reference to the CareTeam which must be message recipient
• careTeamSender: Specify an absolute reference to the CareTeam which must be message sender
• communicationCategory: Specify the desired category using system and code (eg. "http://ehealth.sundhed.dk/message-category/" and "message")
• period: Use a date-type search to filter messages that must conform to temporal constraints (eg. notifications that are only valid until a specific point in time)
• threadId: Specify the logical "thread id" used to correlate messages
• restrictionCategory: Specify the desired restriction category using system and code (eg. "http://ehealth.sundhed.dk/cs/restriction-category" and "measurement-monitoring")
• episodeOfCare: Specify the desired episodeOfCare reference (provided in extension http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare)

Scope and Usage

In the eHealth Infrastructure the ehealth-message resource is used in conjunction with the following resources:

• Patient
  • As sender or recipient of a message
• Practitioner
  • As sender/recipient of a message (only when category is "note")
• Device
  • As sender of an ehealth-message (eg. as a result of automatic processing/triage)
• CareTeam
  • As sender or recipient using the extensions senderCareTeam/recipientCareTeam, respectively

General rules

The following rules apply for the ehealth-message profile:

• If medium.code is eboks or nemsms, the recipient must be of type Patient
• Only one of sender or extension senderCareTeam may be filled in
• Only one of recipient or extension recipientCareTeam may be filled in
• Medium 'nemsms' may only be used if the Patient allows reception of NemSMS (has telecom with value 'NemSMS'). In that case, a NemSMS message will be sent to the Patient.

NemSMS Notifications

The Patient service will forward ehealth-messages to the public Danish NemSMS service given the following conditions:

• message.medium.code is 'nemsms' (defined in http://ehealth.sundhed.dk/cs/message-medium)
• message.status is 'in-progress'

The message is forwarded asynchronously. To track the progress of the NemSMS, the status and statusReason code is used:

• Initially, a NemSMS is sent like any other message by setting the status to 'in-progress'. The status will remain 'in-progress' while the NemSMS is being dispatched.
• If the NemSMS dispatch is successful, status is updated to 'completed' by the server.
• If the NemSMS dispatch fails, status is updated to 'stopped' by the server and statusReason is set to either 'system-error' or 'recipient-unavailable' (defined in http://hl7.org/fhir/R4/valueset-communication-not-done-reason.html)
  • A message.note.text may be added to the message which can contain further information about the reason for dispatch failure in case of 'system-error'

Automatic NemSMS Notifications

Automatic NemSMS notifications is a toggleable feature at the service level. If enabled, the Patient service will generate NemSMS ehealth-messages, notifying the recipient that they have received a message, given the following conditions:

• message.medium.code is not 'nemsms'
• message.status is 'completed'
• message.category is 'message' (defined in http://ehealth.sundhed.dk/cs/message-category)
• message.recipient is a Patient reference
• patient.telecom contains ContactPoint 'NemSMS'

The Patient service will generate NemSMS ehealth-messages, notifying patients that they have an appointment or video appointment scheduled for de following day, given the following conditions:

• appointment.start is current day + 1 day
• appointment.participant contains one Patient reference
• patient.telecom contains ContactPoint 'NemSMS'

Update rules

An ehealth-message may not have its category changed, eg. from 'note' to 'message'.
An ehealth-message may be PATCH updated on paths complying with the regular expressions below (provided that security and status transition rules are obeyed)

• /implicitRules.*
• /contained.*
• /recipient.*
• /definition.*
• /basedOn.*
• /partOf.*
• /topic.*
• /about.*
• /context.*
• /received.*
• /reasonCode.*
• /reasonReference.*
• /payload.*
• /note.*
• /status.*
• /extension.*

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: nemsms-invariant, note-invariant, notification-invariant, message-invariant, advice-invariant
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"
value[x]		1..1	Reference(EpisodeOfCare) {r}	Value of extension
extension:recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
extension:senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
extension:restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
extension:threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
extension:period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
extension:administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
extension:title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
extension:priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
extension:groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
extension:onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
partOf	Σ	0..*	Reference(CarePlan) {r}	Part of this action
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
category:DkTmCategory		1..1	CodeableConcept	Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference	Σ	0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Communication.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Communication.category	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category From the FHIR Standard
Communication.category:DkTmCategory	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category From the FHIR Standard
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code contains 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
dom-2	error	Communication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Communication	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	error	Communication	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	error	Communication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Communication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
message-invariant	error	Communication	Category message invariant : category.coding.code contains 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.content.ofType(string).length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code contains 'note' implies (recipient.reference contains sender.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code contains 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

This structure is derived from Communication

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: nemsms-invariant, note-invariant, notification-invariant, message-invariant, advice-invariant
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
value[x]		1..1	Reference(EpisodeOfCare) {r}	Value of extension
extension:recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
extension:senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
extension:restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
extension:threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
extension:period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
extension:administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
extension:title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
extension:priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
extension:groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
extension:onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
partOf		0..*	Reference(CarePlan) {r}	Part of this action
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system
category:DkTmCategory		1..1	CodeableConcept	Message category
coding
system		1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-category
code		0..1	code	Symbol in syntax defined by the system Binding: MessageCategory (required)
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication
coding
system		1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-medium
code		0..1	code	Symbol in syntax defined by the system Binding: MessageMedium (required)
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode		0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference		0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
note
Slices for author[x]		0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	Individual responsible for the annotation Slice: Unordered, Open by type:$this
author[x]:authorReference		0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString		0..1	string	Individual responsible for the annotation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Communication.category:DkTmCategory.coding.code	required	MessageCategory http://ehealth.sundhed.dk/vs/message-category From this IG
Communication.medium:DkTmMedium.coding.code	required	MessageMedium http://ehealth.sundhed.dk/vs/message-medium From this IG
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code contains 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
message-invariant	error	Communication	Category message invariant : category.coding.code contains 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.content.ofType(string).length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code contains 'note' implies (recipient.reference contains sender.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code contains 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: nemsms-invariant, note-invariant, notification-invariant, message-invariant, advice-invariant
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"
value[x]		1..1	Reference(EpisodeOfCare) {r}	Value of extension
extension:recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
extension:senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
extension:restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
extension:threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
extension:period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
extension:administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
extension:title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
extension:priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
extension:groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
extension:onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique identifier
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(Resource)	Request fulfilled by this communication
partOf	Σ	0..*	Reference(CarePlan) {r}	Part of this action
inResponseTo		0..*	Reference(Communication)	Reply to
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
category:DkTmCategory		1..1	CodeableConcept	Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-category
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Binding: MessageCategory (required)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication.
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-medium
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Binding: MessageMedium (required)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	0..1	Reference(Patient | Group)	Focus of message
topic		0..1	CodeableConcept	Description of the purpose/content Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
about		0..*	Reference(Resource)	Resources that pertain to this communication
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
sent		0..1	dateTime	When sent
received		0..1	dateTime	When received
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference	Σ	0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
note		0..*	Annotation	Comments made about the communication
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for author[x]	Σ	0..1		Individual responsible for the annotation Slice: Unordered, Closed by type:$this
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
author[x]:authorReference	Σ	0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString	Σ	0..1	string	Individual responsible for the annotation
time	Σ	0..1	dateTime	When the annotation was made
text	Σ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Communication.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Communication.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Communication.statusReason	example	CommunicationNotDoneReason http://hl7.org/fhir/ValueSet/communication-not-done-reason From the FHIR Standard
Communication.category	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category From the FHIR Standard
Communication.category:DkTmCategory	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category From the FHIR Standard
Communication.category:DkTmCategory.coding.code	required	MessageCategory http://ehealth.sundhed.dk/vs/message-category From this IG
Communication.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 From the FHIR Standard
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium.coding.code	required	MessageMedium http://ehealth.sundhed.dk/vs/message-medium From this IG
Communication.topic	example	CommunicationTopic http://hl7.org/fhir/ValueSet/communication-topic From the FHIR Standard
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code contains 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
dom-2	error	Communication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Communication	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	error	Communication	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	error	Communication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Communication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
message-invariant	error	Communication	Category message invariant : category.coding.code contains 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.content.ofType(string).length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code contains 'note' implies (recipient.reference contains sender.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code contains 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: nemsms-invariant, note-invariant, notification-invariant, message-invariant, advice-invariant
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"
value[x]		1..1	Reference(EpisodeOfCare) {r}	Value of extension
extension:recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
extension:senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
extension:restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
extension:threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
extension:period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
extension:administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
extension:title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
extension:priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
extension:groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
extension:onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
partOf	Σ	0..*	Reference(CarePlan) {r}	Part of this action
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
category:DkTmCategory		1..1	CodeableConcept	Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference	Σ	0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Communication.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Communication.category	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category From the FHIR Standard
Communication.category:DkTmCategory	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category From the FHIR Standard
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code contains 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
dom-2	error	Communication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Communication	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	error	Communication	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	error	Communication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Communication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
message-invariant	error	Communication	Category message invariant : category.coding.code contains 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.content.ofType(string).length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code contains 'note' implies (recipient.reference contains sender.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code contains 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Differential View

This structure is derived from Communication

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: nemsms-invariant, note-invariant, notification-invariant, message-invariant, advice-invariant
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
value[x]		1..1	Reference(EpisodeOfCare) {r}	Value of extension
extension:recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
extension:senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
extension:restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
extension:threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
extension:period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
extension:administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
extension:title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
extension:priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
extension:groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
extension:onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
partOf		0..*	Reference(CarePlan) {r}	Part of this action
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system
category:DkTmCategory		1..1	CodeableConcept	Message category
coding
system		1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-category
code		0..1	code	Symbol in syntax defined by the system Binding: MessageCategory (required)
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication
coding
system		1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-medium
code		0..1	code	Symbol in syntax defined by the system Binding: MessageMedium (required)
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode		0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference		0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
note
Slices for author[x]		0..1	Reference(Practitioner | Patient | RelatedPerson | Organization), string	Individual responsible for the annotation Slice: Unordered, Open by type:$this
author[x]:authorReference		0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString		0..1	string	Individual responsible for the annotation
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Communication.category:DkTmCategory.coding.code	required	MessageCategory http://ehealth.sundhed.dk/vs/message-category From this IG
Communication.medium:DkTmMedium.coding.code	required	MessageMedium http://ehealth.sundhed.dk/vs/message-medium From this IG
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code contains 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
message-invariant	error	Communication	Category message invariant : category.coding.code contains 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.content.ofType(string).length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code contains 'note' implies (recipient.reference contains sender.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code contains 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver Constraints: nemsms-invariant, note-invariant, notification-invariant, message-invariant, advice-invariant
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:episodeOfCare		0..1	(Complex)	Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare"
value[x]		1..1	Reference(EpisodeOfCare) {r}	Value of extension
extension:recipientCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
extension:senderCareTeam		0..1	Reference(ehealth-careteam) {r}	CareTeam message sender URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
extension:restrictionCategory		0..*	CodeableConcept	Restriction category URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category Binding: Restriction Category (required)
extension:threadId		0..1	string	Thread id URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
extension:period		0..*	Period	Specifies the temporal validity of an ehealth/message instance URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
extension:administrativeStatus		1..1	Coding	The administrative status of how a message recipient has handled a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status Binding: Administrative Status (required)
extension:title		0..1	string	Message title URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
extension:priority		0..1	code	The priority of a message URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority Binding: Priority (required)
extension:groupId		0..1	string	Logical id identifying a set of messages with the same recipient URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
extension:onBehalfOf	S	0..1	Reference(ehealth-careteam) {r}	On behalf of URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Unique identifier
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(Resource)	Request fulfilled by this communication
partOf	Σ	0..*	Reference(CarePlan) {r}	Part of this action
inResponseTo		0..*	Reference(Communication)	Reply to
status	?!Σ	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): The status of the communication.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: CommunicationNotDoneReason (example): Codes for the reason why a communication did not happen.
Slices for category		1..*	CodeableConcept	Message category Slice: Unordered, Open by value:coding.system Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
category:DkTmCategory		1..1	CodeableConcept	Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instructions, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-category
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Binding: MessageCategory (required)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication.
Slices for medium		0..*	CodeableConcept	A channel of communication Slice: Unordered, Open by value:coding.system Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
medium:DkTmMedium		0..1	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://ehealth.sundhed.dk/cs/message-medium
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Binding: MessageMedium (required)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	0..1	Reference(Patient | Group)	Focus of message
topic		0..1	CodeableConcept	Description of the purpose/content Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
about		0..*	Reference(Resource)	Resources that pertain to this communication
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
sent		0..1	dateTime	When sent
received		0..1	dateTime	When received
recipient		0..1	Reference(Patient | Practitioner) {r}	Message recipient
sender		0..1	Reference(Device | Patient | Practitioner) {r, c}	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: eHealth Message Reason Code (required)
reasonReference	Σ	0..*	Reference(Condition | Observation) {r}	Why was communication done?
payload		0..1	BackboneElement	Message payload
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]		1..1	string	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentString		1..1	string	Message part content
note		0..*	Annotation	Comments made about the communication
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for author[x]	Σ	0..1		Individual responsible for the annotation Slice: Unordered, Closed by type:$this
authorReference			Reference(Practitioner | Patient | RelatedPerson | Organization)
authorString			string
author[x]:authorReference	Σ	0..1	Reference(ehealth-practitioner | ehealth-patient | ehealth-relatedperson)	Individual responsible for the annotation
author[x]:authorString	Σ	0..1	string	Individual responsible for the annotation
time	Σ	0..1	dateTime	When the annotation was made
text	Σ	1..1	markdown	The annotation - text content (as markdown)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Communication.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Communication.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status|4.0.1 From the FHIR Standard
Communication.statusReason	example	CommunicationNotDoneReason http://hl7.org/fhir/ValueSet/communication-not-done-reason From the FHIR Standard
Communication.category	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category From the FHIR Standard
Communication.category:DkTmCategory	example	CommunicationCategory http://hl7.org/fhir/ValueSet/communication-category From the FHIR Standard
Communication.category:DkTmCategory.coding.code	required	MessageCategory http://ehealth.sundhed.dk/vs/message-category From this IG
Communication.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 From the FHIR Standard
Communication.medium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium	example	ParticipationMode http://terminology.hl7.org/ValueSet/v3-ParticipationMode
Communication.medium:DkTmMedium.coding.code	required	MessageMedium http://ehealth.sundhed.dk/vs/message-medium From this IG
Communication.topic	example	CommunicationTopic http://hl7.org/fhir/ValueSet/communication-topic From the FHIR Standard
Communication.reasonCode	required	eHealth Message Reason Code http://ehealth.sundhed.dk/vs/message-reasonCode From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
advice-invariant	error	Communication	Category advice invariant : category.coding.code contains 'advice' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())
dom-2	error	Communication	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Communication	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	error	Communication	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	error	Communication	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Communication	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
message-invariant	error	Communication	Category message invariant : category.coding.code contains 'message' implies (recipient.reference.contains('Patient/') and ( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists())) or (( extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and (sender.reference.contains('Patient/')) or (extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam').value.as(Reference).exists() ))
nemsms-invariant	error	Communication	If communication resource is a NemSMS payload cannot exceed 160 : medium.coding.where(code = 'nemsms').exists() implies payload.content.ofType(string).length() <= 160
note-invariant	error	Communication	Category note invariant : category.coding.code contains 'note' implies (recipient.reference contains sender.reference) or (recipient.reference.exists().not() and extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists())
notification-invariant	error	Communication	Category notification invariant : category.coding.code contains 'notification' implies (recipient.reference.contains('Patient/') or extension.where(url = 'http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam').value.as(Reference).exists()) and ( sender.reference.contains('Device/') or contained.ofType(Device).where('#' + id = %resource.sender.reference).empty().not())

This structure is derived from Communication

Summary

Mandatory: 4 elements(3 nested mandatory elements)
Must-Support: 1 element

Structures

This structure refers to these other structures:

• ehealth-practitioner (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-practitioner)
• ehealth-patient (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-patient)
• ehealth-relatedperson (http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-relatedperson)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-recipientCareTeam
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-communication-senderCareTeam
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-restriction-category
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-thread-id
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-period
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-administrative-status
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-title
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-priority
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-group-id
• http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-on-behalf-of

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Communication.category
• The element 1 is sliced based on the value of Communication.medium
• The element 1 is sliced based on the value of Communication.payload.content[x] (Closed)
• The element 1 is sliced based on the value of Communication.note.author[x]