Care Directory HL7 Europe Core - Practitioner

Reference

• NHS England HL7 v2 XCN ADT Message Specification
• HL7 v2 XCN Extended Composite ID Number and Name for Persons
• IHE Mobile Care Services Discovery (mCSD)

Practitioner (Resource) or Reference by Practitioner Identity

In message paradigms, especially HL7 v2 laboratory order (OML_O21/ORM_O01) and unsolicitied observations (ORU_R01) it is common to use the XCN (Extended Composite Id Number And Name For Persons). The FHIR equivalent to this datatype is FHIR Reference

For example:

HL7 v2 XCN

C3456789^Darwin^Samuel^^^Dr^^^GMC

HL7 FHIR Reference

{
    "reference" : "Practitioner/1234",
    "type" : "Practitioner",
    "identifier" : {
      "system" : "https://fhir.hl7.org.uk/Id/gmc-number",
      "value" : "C3456789"
    },
    "display" : "Dr Darwin, Samuel"
}

FHIR Reference introduces a reference to a detailed version of Practitioner which includes fields such as telecom and gender.

It is not clear in Enterprise/Regional use of FHIR which approach Resource or Reference should be taken, both HL7 v2 and FHIR support Reference aggregate or entities by identity from Dommain Driven Design (DDD) and this appears to also be followed by IHE XDS and DICOM. In addition, NHS England Data Dictionary and NHS England HL7 v2 ADT Message Specification favour Reference NHS England FHIR STU3/R4 specifications around Messaging, tend to favour Resource.

It is likely that the reference may be able to point to Care Service Directory services provided by NHS England Healthcare Worker - FHIR API in the near future,(or alternatively downloaded from NHS England Organisation Data Service - CSV Downloads. Therefore: it is proposed:

Reference by Practitioner Identity only

and so continuing conventions used in HL7 v2, i.e. no Practitioner resources will be present in FHIR Messaging.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner	C	0..*	PractitionerEuCore	A person with a formal responsibility in the provisioning of healthcare or related services Constraints: name-or-identifier
Practitioner.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Practitioner.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Practitioner.Slices for identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	Practitioner identifier Slice: Unordered, Open by value:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Practitioner.Slices for identifier.identifier:All Slices				Content/Rules for all slices
Practitioner.Slices for identifier.identifier:All Slices.use	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
Practitioner.Slices for identifier.identifier:All Slices.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Practitioner.Slices for identifier.identifier:All Slices.value	Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
Practitioner.Slices for identifier.identifier:PractitionerIdentifier	S This element must be supported. Σ This element is included in summaries.	1..1	PractitionerIdentifier	Practitioner identifier
Practitioner.name	S This element must be supported. Σ This element is included in summaries.	1..*	HumanName	Practitioner Name
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Practitioner.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from PractitionerEuCore

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner			PractitionerEuCore
Practitioner.Slices for identifier	S This element must be supported.	1..*	Identifier	Practitioner identifier Slice: Unordered, Open by value:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Practitioner.Slices for identifier.identifier:All Slices				Content/Rules for all slices
Practitioner.Slices for identifier.identifier:All Slices.system		1..1	uri	The namespace for the identifier value
Practitioner.Slices for identifier.identifier:All Slices.value		1..1	string	The value that is unique
Practitioner.Slices for identifier.identifier:PractitionerIdentifier	S This element must be supported.	1..1	PractitionerIdentifier	Practitioner identifier
Practitioner.name	S This element must be supported.	1..*	HumanName	Practitioner Name
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner	C	0..*	PractitionerEuCore	A person with a formal responsibility in the provisioning of healthcare or related services Constraints: name-or-identifier
Practitioner.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Practitioner.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Practitioner.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Practitioner.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Practitioner.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
Practitioner.contained		0..*	Resource	Contained, inline Resources
Practitioner.extension		0..*	Extension	Additional content defined by implementations
Practitioner.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Practitioner.Slices for identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	Practitioner identifier Slice: Unordered, Open by value:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Practitioner.Slices for identifier.identifier:All Slices				Content/Rules for all slices
Practitioner.Slices for identifier.identifier:All Slices.id		0..1	string	Unique id for inter-element referencing
Practitioner.Slices for identifier.identifier:All Slices.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Practitioner.Slices for identifier.identifier:All Slices.use	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
Practitioner.Slices for identifier.identifier:All Slices.type	Σ This element is included in summaries.	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Practitioner.Slices for identifier.identifier:All Slices.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Practitioner.Slices for identifier.identifier:All Slices.value	Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
Practitioner.Slices for identifier.identifier:All Slices.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
Practitioner.Slices for identifier.identifier:All Slices.assigner	Σ This element is included in summaries.	0..1	Reference(Organization)	Organization that issued id (may be just text)
Practitioner.Slices for identifier.identifier:PractitionerIdentifier	S This element must be supported. Σ This element is included in summaries.	1..1	PractitionerIdentifier	Practitioner identifier
Practitioner.active	Σ This element is included in summaries.	0..1	boolean	Whether this practitioner's record is in active use
Practitioner.name	S This element must be supported. Σ This element is included in summaries.	1..*	HumanName	Practitioner Name
Practitioner.telecom	Σ This element is included in summaries.	0..*	ContactPoint	Contact details for the practitioner
Practitioner.address	Σ This element is included in summaries.	0..*	AddressEu	Address(es) of the practitioner that are not role specific (typically home address)
Practitioner.gender	Σ This element is included in summaries.	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
Practitioner.birthDate	Σ This element is included in summaries.	0..1	date	The date on which the practitioner was born
Practitioner.photo		0..*	Attachment	Image of the person
Practitioner.qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
Practitioner.qualification.id		0..1	string	Unique id for inter-element referencing
Practitioner.qualification.extension		0..*	Extension	Additional content defined by implementations
Practitioner.qualification.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Practitioner.qualification.identifier		0..*	Identifier	An identifier for this qualification for the practitioner
Practitioner.qualification.code		1..1	CodeableConcept	Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
Practitioner.qualification.period		0..1	Period	Period during which the qualification is valid
Practitioner.qualification.issuer		0..1	Reference(Organization)	Organization that regulates and issues the qualification
Practitioner.communication		0..*	CodeableConcept	A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Practitioner.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Practitioner.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Practitioner.gender	Base	required	AdministrativeGender	📍4.0.1	FHIR Std.
Practitioner.qualification.​code	Base	example	v2 table 0360, Version 2.7	📦0360	FHIR Std.
Practitioner.communication	Base	preferred	Common Languages	📍4.0.1	FHIR Std.

Constraints

Id

Grade

Path(s)

Description

Expression

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner	C	0..*	PractitionerEuCore	A person with a formal responsibility in the provisioning of healthcare or related services Constraints: name-or-identifier
Practitioner.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Practitioner.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Practitioner.Slices for identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	Practitioner identifier Slice: Unordered, Open by value:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Practitioner.Slices for identifier.identifier:All Slices				Content/Rules for all slices
Practitioner.Slices for identifier.identifier:All Slices.use	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
Practitioner.Slices for identifier.identifier:All Slices.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Practitioner.Slices for identifier.identifier:All Slices.value	Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
Practitioner.Slices for identifier.identifier:PractitionerIdentifier	S This element must be supported. Σ This element is included in summaries.	1..1	PractitionerIdentifier	Practitioner identifier
Practitioner.name	S This element must be supported. Σ This element is included in summaries.	1..*	HumanName	Practitioner Name
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Practitioner.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.

Constraints

Id

Grade

Path(s)

Description

Expression

Differential View

This structure is derived from PractitionerEuCore

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner			PractitionerEuCore
Practitioner.Slices for identifier	S This element must be supported.	1..*	Identifier	Practitioner identifier Slice: Unordered, Open by value:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Practitioner.Slices for identifier.identifier:All Slices				Content/Rules for all slices
Practitioner.Slices for identifier.identifier:All Slices.system		1..1	uri	The namespace for the identifier value
Practitioner.Slices for identifier.identifier:All Slices.value		1..1	string	The value that is unique
Practitioner.Slices for identifier.identifier:PractitionerIdentifier	S This element must be supported.	1..1	PractitionerIdentifier	Practitioner identifier
Practitioner.name	S This element must be supported.	1..*	HumanName	Practitioner Name
Documentation for this format

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Practitioner	C	0..*	PractitionerEuCore	A person with a formal responsibility in the provisioning of healthcare or related services Constraints: name-or-identifier
Practitioner.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Practitioner.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Practitioner.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Practitioner.language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Practitioner.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
Practitioner.contained		0..*	Resource	Contained, inline Resources
Practitioner.extension		0..*	Extension	Additional content defined by implementations
Practitioner.modifierExtension	?! This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
Practitioner.Slices for identifier	S This element must be supported. Σ This element is included in summaries.	1..*	Identifier	Practitioner identifier Slice: Unordered, Open by value:type Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Practitioner.Slices for identifier.identifier:All Slices				Content/Rules for all slices
Practitioner.Slices for identifier.identifier:All Slices.id		0..1	string	Unique id for inter-element referencing
Practitioner.Slices for identifier.identifier:All Slices.extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Practitioner.Slices for identifier.identifier:All Slices.use	?! This element is a modifier element. Σ This element is included in summaries.	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
Practitioner.Slices for identifier.identifier:All Slices.type	Σ This element is included in summaries.	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Practitioner.Slices for identifier.identifier:All Slices.system	Σ This element is included in summaries.	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
Practitioner.Slices for identifier.identifier:All Slices.value	Σ This element is included in summaries.	1..1	string	The value that is unique Example General: 123456
Practitioner.Slices for identifier.identifier:All Slices.period	Σ This element is included in summaries.	0..1	Period	Time period when id is/was valid for use
Practitioner.Slices for identifier.identifier:All Slices.assigner	Σ This element is included in summaries.	0..1	Reference(Organization)	Organization that issued id (may be just text)
Practitioner.Slices for identifier.identifier:PractitionerIdentifier	S This element must be supported. Σ This element is included in summaries.	1..1	PractitionerIdentifier	Practitioner identifier
Practitioner.active	Σ This element is included in summaries.	0..1	boolean	Whether this practitioner's record is in active use
Practitioner.name	S This element must be supported. Σ This element is included in summaries.	1..*	HumanName	Practitioner Name
Practitioner.telecom	Σ This element is included in summaries.	0..*	ContactPoint	Contact details for the practitioner
Practitioner.address	Σ This element is included in summaries.	0..*	AddressEu	Address(es) of the practitioner that are not role specific (typically home address)
Practitioner.gender	Σ This element is included in summaries.	0..1	code	male | female | other | unknown Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.
Practitioner.birthDate	Σ This element is included in summaries.	0..1	date	The date on which the practitioner was born
Practitioner.photo		0..*	Attachment	Image of the person
Practitioner.qualification		0..*	BackboneElement	Certification, licenses, or training pertaining to the provision of care
Practitioner.qualification.id		0..1	string	Unique id for inter-element referencing
Practitioner.qualification.extension		0..*	Extension	Additional content defined by implementations
Practitioner.qualification.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Practitioner.qualification.identifier		0..*	Identifier	An identifier for this qualification for the practitioner
Practitioner.qualification.code		1..1	CodeableConcept	Coded representation of the qualification Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.
Practitioner.qualification.period		0..1	Period	Period during which the qualification is valid
Practitioner.qualification.issuer		0..1	Reference(Organization)	Organization that regulates and issues the qualification
Practitioner.communication		0..*	CodeableConcept	A language the practitioner can use in patient communication Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Practitioner.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Practitioner.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Practitioner.identifier.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Practitioner.gender	Base	required	AdministrativeGender	📍4.0.1	FHIR Std.
Practitioner.qualification.​code	Base	example	v2 table 0360, Version 2.7	📦0360	FHIR Std.
Practitioner.communication	Base	preferred	Common Languages	📍4.0.1	FHIR Std.

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from PractitionerEuCore

Summary

Mandatory: 4 elements
Must-Support: 3 elements

Structures

This structure refers to these other structures:

• Practitioner Identifier (https://fhir.nwgenomics.nhs.uk/StructureDefinition/PractitionerIdentifier)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Practitioner.identifier