Sveikatos priežiūros specialisto rolė įstaigoje / Practitioner role in organization
Roles/organizations the practitioner is associated with
A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
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()
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
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.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
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.
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 its narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
The base language in which the resource is written.
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).
Text summary of the resource, for human interpretation
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.
Contained resources do not have a 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.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
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.
Must have either extensions or value[x], not both
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 managable, 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).
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.
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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Business Identifiers that are specific to a role/location.
A specific identifier value (e.g. Minnesota Registration ID) may appear on multiple PractitionerRole instances which could be for different periods, or different Roles (or other reasons). A specific identifier may be included multiple times in the same PractitionerRole instance with different identifier validity periods.
Often, specific identities are assigned for the agent.
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
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 managable, 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.
usual | official | temp | secondary | old (If known)
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Identifies the purpose for this identifier, if known .
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Allows users to make use of identifiers when the identifier system is not known.
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Identifier.system is always case sensitive.
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Time period when id is/was valid for use
Time period during which identifier is/was valid for use.
Role.effectiveTime or implied by context
Organization that issued id (may be just text)
Organization that issued/manages the identifier.
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
ESPBI Practitioner resurso identifikatorius / ESPBI Practitioner id
Whether this practitioner role record is in active use
Whether this practitioner role record is in active use. Some systems may use this property to mark non-active practitioners, such as those that are not currently employed.
If this value is false, you may refer to the period to see when the role was in active use. If there is no period specified, no inference can be made about when it was active.
Need to be able to mark a practitioner role record as not to be used because it was created in error, or otherwise no longer in active use.
This resource is generally assumed to be active if no value is provided for the active element
Laiko periodas, kuriuo specialistas turi šią rolę įstaigoje / The period during which the practitioner is authorized to perform in these role(s)
The period during which the person is authorized to act as a practitioner in these role(s) for the organization.
If a practitioner is performing a role within an organization over multiple, non-adjacent periods, there should be a distinct PractitionerRole instance for each period. For example, if a nurse is employed at a hospital, leaves the organization for a period of time due to pandemic related stress, but returns post-pandemic to the same job role, there would be two PractitionerRole instances for the different periods of employment.
Even after the agencies is revoked, the fact that it existed must still be recorded.
.performance[@typeCode <= 'PPRF'].ActDefinitionOrEvent.effectiveTime
(ServD maps Practitioners and Organizations via another entity, so this concept is not available)
Specialistas / Practitioner that provides services for the organization
Practitioner that is able to provide the defined services for the organization.
Įstaiga, kurioje dirba šis specialistas (arba padalinys, jei dirbama ne tėvinėje įstaigoje) / Practitioner workplace organization (or subunit, if working outside the parent organization)
The organization where the Practitioner performs the roles associated.
Specialisto vaidmuo įstaigoje / Roles which this practitioner may perform
Roles which this practitioner is authorized to perform for the organization.
Need to know what authority the practitioner has - what can they do?
The role a person plays representing an organization.
A reference to a code defined by a terminology system.
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.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
The identification of the code system that defines the meaning of the symbol in the code.
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 be an absolute reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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.
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.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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).
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
A representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
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.
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.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Plain text representation of the concept
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.
Very often the text is the same as a displayName of one of the codings.
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.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Specialisto profesija / Specific specialty of the practitioner
The specialty of a practitioner that describes the functional role they are practicing at a given organization or location.
The specialty represents the functional role a practitioner is playing within an organization/location. This role may require the individual have certain qualifications, which would be represented in the Practitioner.qualifications property. Note that qualifications may or might not relate to or be required by the practicing specialty.
Specific specialty associated with the agency.
.player.HealthCareProvider[@classCode = 'PROV'].code
Location(s) where the practitioner provides care
The location(s) at which this practitioner provides care.
.performance.ActDefinitionOrEvent.ServiceDeliveryLocation[@classCode = 'SDLOC']
(ServD maps Practitioners and Organizations via another entity, so this concept is not available) However these are accessed via the Site.ServiceSite.ServiceSiteProvider record. (The Site has the location)
Healthcare services provided for this role's Organization/Location(s)
The list of healthcare services that this worker provides for this role's Organization/Location(s).
.player.QualifiedEntity[@classCode = 'QUAL'].code
Specialisto darbo vietos kontaktinė informacija / Official contact details relating to this PractitionerRole
The contact details of communication devices available relevant to the specific PractitionerRole. This can include addresses, phone numbers, fax numbers, mobile numbers, email addresses and web sites.
Often practitioners have a dedicated line for each location (or service) that they work at, and need to be able to define separate contact details for each of these. Sometimes these also include a named person/organization that handles contact for specific purposes, such as a receptionist, or accounts clerk etc.
If no purpose is defined, then these contact details may be used for any purpose.
The purpose for which an extended contact detail should be used.
The name of an individual to contact, some types of contact detail are usually blank.
If there is no named individual, the telecom/address information is not generally monitored by a specific individual.
The contact details application for the purpose defined.
phone | fax | email | pager | url | sms | other
Telecommunications form for contact point - what communications system is required to make use of the contact.
Telecommunications form for contact point.
The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Need to support legacy numbers that are not in a tightly controlled format.
home | work | temp | old | mobile - purpose of this contact point
Identifies the purpose for the contact point.
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
Specify preferred order of use (1 = highest)
Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Note that rank does not necessarily follow the order in which the contacts are represented in the instance. Ranks need not be unique. E.g. it's possible to have multiple contacts with rank=1. If the ranks have different systems or uses, this would be interpreted to mean "X is my most preferred phone number, Y is my most preferred email address" or "X is my preferred home email and Y is my preferred work email". If the system and use for equally-ranked contacts are the same, then the level of preference is equivalent for both repetitions. Ranks need not be sequential and not all repetitions must have a rank. For example, it's possible to have 4 contacts with ranks of 2, 5 and two with no rank specified. That would be interpreted to mean the first is preferred over the second and no preference stated for the remaining contacts.
Time period when the contact point was/is in use
Time period when the contact point was/is in use.
More than 1 address would be for different purposes, and thus should be entered as a different entry,.
This contact detail is handled/monitored by a specific organization
This contact detail is handled/monitored by a specific organization. If the name is provided in the contact, then it is referring to the named individual within this organization.
Some specific types of contact information can be an handled by an organization (eg legal council is via a specific firm).
Period that this contact was valid for usage
Period that this contact was valid for usage.
If the details have multiple periods, then enter in a new ExtendedContact with the new period.
Collection of characteristics (attributes)
Collection of characteristics (attributes).
These could be such things as is the service mode used by this role.
A custom attribute that could be provided at a service (e.g. Wheelchair accessibility).
A language the practitioner (in this role) can use in patient communication
A language the practitioner can use in patient communication. The practitioner may know several languages (listed in practitioner.communication), however these are the languages that could be advertised in a directory for a patient to search.
The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type. Note that for non-patient oriented communication, see Practitioner.communication. Note that all 'person' type resources (Person, RelatedPerson, Patient, Practitioner) have a communication structure that includes preferences. Role or service oriented resources such as HealthcareService and PractitionerRole only include languages that are available for interacting with patients.
Knowing which language a practitioner speaks can help in facilitating patients to locate practitioners that speak their language.
Times the Practitioner is available at this location and/or healthcare service (including exceptions)
A collection of times the practitioner is available or performing this role at the location and/or healthcareservice.
More detailed availability information may be provided in associated Schedule/Slot resources. Systems may choose to render availability differently than it is exchanged on the interface. For example, rather than "Mon, Tue, Wed, Thur, Fri from 9am-12am; Mon, Tue, Wed, Thur, Fri from 1pm-5pm" as would be implied by two availableTime repetitions, an application could render this information as "Mon-Fri 9-12am and 1-5pm". The NotAvailableTime(s) included indicate the general days/periods where the practitioner is not available (for things such as vacation time, or public holidays).
Endpoints for interacting with the practitioner in this role
Technical endpoints providing access to services operated for the practitioner with this role. Commonly used for locating scheduling services, or identifying where to send referrals electronically.
Organizations have multiple systems that provide various services and may also be different for practitioners too. So the endpoint satisfies the need to be able to define the technical connection details for how to connect to them, and for what purpose.