Scope and usage

This profile is used as the Communication resource for the MedCom CareCommunication message. MedComCareCommunication contains the main content of a message, which includes at least one message segment with a message text (Danish: Meddelelsestekst) and a signature, and it may include zero or more message segments with an attachment and a signature. All message segments are found under the element Communication.payload. A more detailed description of the content of the MedComCareCommunication profile can be seen below.

The figure below shows the possible references from MedComCareCommunication profile, and thereby which resources that may be included in a CareCommunication message. A subject, in terms of a MedComCorePatient, shall always be included since a CareCommunication message always concerns a patient’s matter. A MedComCorePractitionerRole and MedComCorePractitioner shall be included since these reference includes information about the author of the message text or attachment. A MedComCoreEncounter may be referenced if an episodeOfCare-identifier (Danish: forløbs-id) is relevant to include. Further, the Danish Core Organization Profile, MedComCoreOrganization,MedComCorePractitionerRole or MedComCorePractitioner may be included if a recipient or sender is added.

Please refer to the tab “Snapshot Table(Must support)” below for the definition of the required content of a MedComCareCommunication.

Categories and Topic

All MedCom CareCommunication messages shall have a category (Danish: Kategori), in the element Communication.category. The category describes the overall content of the communication and shall be selected from a nationally agreed list of categories defined in the ValueSet of category codes. In time new category codes may be relevant to include or existing codes may be irrelevant, why it should be expected that the ValueSet will changed. Changes will be made in agreement with the business and will be warned.

In addition to the category, it is allowed to add a topic (Danish: Emne) in the element Communication.topic, to support and elaborate the category. This can either be inserted as free text or as regionally agreed codes, which is describes further in the clinical guidelines for application. When answering and forwarding a CareCommunication message, the same category and topic from the previous message should be inserted automatically. The user then has the option to change it to a different category and a different topic if desired.

When sending a CareCommunication message with the category other, a topic shall be included. To ensure this, the invariant medcom-careCommunication-6 is created. The invariant can be found the on MedComCareCommunicationMessage.

Priority

Priority, found in the element Communication.priority, may be used to support the referral flow. It is only allowed to add a priority of a CareCommunication message when the category of the message is regarding referral. In this case priority can either be routine or asap. To insure this, the invariant medcom-careCommunication-5 is created, which states that in no other case than when the category is regarding referral, may a priority be added. As describes on clinical guidelines for application, the use of priority must follow the development in collective agreements and on basis of national requirements.

Encounter

In the element Communication.encounter it is possible to reference a MedComCoreEncounter profile. An encounter describes the meeting between a patient and one or more healthcare providers or actors involved in the patient care. An example where this is relevant could be when the communication concerns a hospitalisation of a patient, where an episodeOfCare-identifier is used to connect the communication and hospitalisation. In this case, should a reference to the MedComCoreEncounter and episodeOfCare-identifier be included.

Recipient and sender

In the MedComCareCommunicationMessageHeader profile it is required to include information about a sender and receiver in terms of a reference to a MedComMessagingOrganization. This information is primarily used for transportation matters and will always include an EAN-number and SOR-identifier for each organisation.

When sending a CareCommunication message it is possible to add a more specific receiver of the message, called a recipient, and a more specific sender, which can be found in the elements Communication.recipient and Communication.extension.sender, respectively. It is allowed to reference a MedComCoreCareTeam, which is people or an organization participating a coordination or delivery of patientcare, or MedComCorePractitionerRole, which references a MedComCorePractitioner to address a professionals involved in patient care. Common for both MedComCoreCareTeam and MedComCorePractitionerRole/MedComCorePractitioner is that a name of the careteam or practitioner shall be included as well as a reference to a MedComCoreOrganization which shall be sender og receiver defined in MedComCareCommunicationMessageHeader.

Message segments

A message segment consist of a message text or an attachment and a signature which includes an author (Danish: forfatter), authorrole (Danish: stillingsbetegnelse), a timestamp and a relevant phone number. For an attachment an identifier shall also be included. These informations are described below for each of the payload types, message text and attachments.

The message text and attachments will both be included in the element Communication.payload, however they shall be included in different slices. At least one payload which includes the message text shall be included when sending a CareCommunication message, but zero or more attachments may be included.

Message text

The written content of the message is of the datatype string defined by FHIR, and it shall obey a subset of xhtml.
Author: The person responsible for writing the message text. The author shall be described using a MedComCorePractitioner.
Author role: The role of the person responsible for writing the message text. The author role shall be described using a MedComCorePractitionerRole.
Timestamp: The date and time for when the message is sent.
Relevant phone number: A relevant phone number e.g. to the department from which the CareCommunication is sent. The phone number should be applied automatically and it is recommended to use the same phone number as in the SOR-register for the sender organisation. In case it is not possible to apply the phone number automatically, it shall be applied be the author.

Attachments

An attachment shall be of the type pdf, jpeg, png, tiff or gif.
Author: The person responsible for writing or attaching the attachment. As mentioned in the clinical guidelines for application, are both the author of an attachment and the person who the attaches the attachment responsible for the content. It is recommended that the author of the attachment is used as the author, why information about this person shall be included when sending a CareCommunication message. Alternatively, can the author of the message be used as the author, hence the person attaching the attachment. In both cases shall the author be described using a MedComCorePractitioner.

Author role: The role person responsible for writing or attaching the attachment. Is shall reflect the person used as author. The author role shall be described using a MedComCorePractitionerRole.
Timestamp: The date and time for when the message is sent.

Creation: The date and time for when the attachment is created.

Identifier: An UUID with a reference to the sending organisation. The assigner is a reference to the organisation who assigned the UUID, which will be the same as the sender organisation. If the attachment is modified and reattached, it shall be given a new UUID and the assigner shall be updated.
Relevant phone number: A relevant phone number e.g. to the department from which the CareCommunication is sent. The phone number should be applied automatically without user interference and it is recommended to use the same phone number as in the SOR-register for the sender organisation. In case it is not possible to apply the phone number automatically, it shall be applied be the author.

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

This structure is derived from Communication

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver medcom-careCommunication-5: Priority is only allowed when Communication.category = 'regarding-referral' medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. medcom-careCommunication-9: When an attachment is included, it shall have an identifier medcom-careCommunication-10: The status shall be 'unknown' or 'entered-in-error'.
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
sender	SΣ	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-sender-extension
status	S	1..1	code	The status may be 'unknown' or 'entered-in-error', dependning on the type of message. status is required because of basic FHIR profile requirement
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
priority	S	0..1	code	Shall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5 Binding: MedComCareCommunicationRequestPriorityCodes (required)
subject	S	1..1	Reference(MedComCorePatient) {b}	Focus of message
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category.
encounter	S	0..1	Reference(MedComCoreEncounter) {b}	Shall contain an encounter with a reference to the episodeOfCare-identifier if reported to the Danish National Patient Registry
recipient	S	0..*	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a signature and a message text or attachment. At least one payload with a message text shall be included. Slice: Ordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
identifier	SΣ	0..1	MedComCareCommunicationAttachmentIdentifier	AttachmentIdentifierExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension
payload:string	S	1..*	BackboneElement	xhtml content of the message
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
content[x]	S	1..1	string	Message part content
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain all links or content attached to the message.
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
content[x]	S	1..1	Attachment	Message part content Slice: Unordered, Open by type:$this
contentAttachment	S	1..1	Attachment	Message part content
contentType	S	0..1	code	The content type shall be present in case the content is provided as an attached document (data) or links to a document. Binding: MedComCoreAttachmentMimeTypes (required)
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content if the attachment is an attached document
url	S	0..1	url	Shall be present if the attachment is a link to a document or a web page
title	S	1..1	string	Label to display in place of the data
creation	S	1..1	dateTime	The time the attachment was created
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Communication.category	required	MedComCareCommunicationCategories
Communication.priority	required	MedComCareCommunicationRequestPriority
Communication.payload:attachment.contentAttachment.contentType	required	MedComCoreAttachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-careCommunication-5	error	Communication	Priority is only allowed when Communication.category = 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	There shall exist a Communication.topic when Communication.category = 'other' : iif(category.coding.code != 'other', true, category.coding.code = 'other' and topic.exists())
medcom-careCommunication-7	error	Communication	There shall exist a practitioner role when using a PractitionerRole as author in a message segment. : payload.extension.value.reference.resolve().code.coding.code.exists()
medcom-careCommunication-8	error	Communication	There shall exist a practitioner name when using a Practitioner as author in a message segment. : payload.extension.value.reference.resolve().practitioner.resolve().name.exists()
medcom-careCommunication-9	error	Communication	When an attachment is included, it shall have an identifier : payload.where(content.data.exists()).extension('http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension').exists() or payload.content.data.exists().not()
medcom-careCommunication-10	error	Communication	The status shall be 'unknown' or 'entered-in-error'. : status='unknown' or status='entered-in-error'

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver medcom-careCommunication-5: Priority is only allowed when Communication.category = 'regarding-referral' medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. medcom-careCommunication-9: When an attachment is included, it shall have an identifier medcom-careCommunication-10: The status shall be 'unknown' or 'entered-in-error'.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
sender	SΣ	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-sender-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	The status may be 'unknown' or 'entered-in-error', dependning on the type of message. status is required because of basic FHIR profile requirement Binding: EventStatus (required): The status of the communication.
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
priority	SΣ	0..1	code	Shall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5 Binding: MedComCareCommunicationRequestPriorityCodes (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	Focus of message
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
encounter	SΣ	0..1	Reference(MedComCoreEncounter) {b}	Shall contain an encounter with a reference to the episodeOfCare-identifier if reported to the Danish National Patient Registry
recipient	S	0..*	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a signature and a message text or attachment. At least one payload with a message text shall be included. Slice: Ordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
identifier	SΣ	0..1	MedComCareCommunicationAttachmentIdentifier	AttachmentIdentifierExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
payload:string	S	1..*	BackboneElement	xhtml content of the message
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	S	1..1	string	Message part content
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain all links or content attached to the message.
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]	S	1..1	Attachment	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentAttachment	S	1..1	Attachment	Message part content
contentType	SΣ	0..1	code	The content type shall be present in case the content is provided as an attached document (data) or links to a document. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content if the attachment is an attached document
url	SΣ	0..1	url	Shall be present if the attachment is a link to a document or a web page Example General: http://www.acme.com/logo-small.png
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	The time the attachment was created
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Communication.status	required	EventStatus
Communication.category	required	MedComCareCommunicationCategories
Communication.priority	required	MedComCareCommunicationRequestPriority
Communication.topic	example	CommunicationTopic
Communication.payload:attachment.content[x]:contentAttachment.contentType	required	MedComCoreAttachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
medcom-careCommunication-5	error	Communication	Priority is only allowed when Communication.category = 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	There shall exist a Communication.topic when Communication.category = 'other' : iif(category.coding.code != 'other', true, category.coding.code = 'other' and topic.exists())
medcom-careCommunication-7	error	Communication	There shall exist a practitioner role when using a PractitionerRole as author in a message segment. : payload.extension.value.reference.resolve().code.coding.code.exists()
medcom-careCommunication-8	error	Communication	There shall exist a practitioner name when using a Practitioner as author in a message segment. : payload.extension.value.reference.resolve().practitioner.resolve().name.exists()
medcom-careCommunication-9	error	Communication	When an attachment is included, it shall have an identifier : payload.where(content.data.exists()).extension('http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension').exists() or payload.content.data.exists().not()
medcom-careCommunication-10	error	Communication	The status shall be 'unknown' or 'entered-in-error'. : status='unknown' or status='entered-in-error'

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver medcom-careCommunication-5: Priority is only allowed when Communication.category = 'regarding-referral' medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. medcom-careCommunication-9: When an attachment is included, it shall have an identifier medcom-careCommunication-10: The status shall be 'unknown' or 'entered-in-error'.
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
sender	SΣ	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-sender-extension
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(Resource)	Part of this action
inResponseTo		0..*	Reference(Communication)	Reply to
status	?!SΣ	1..1	code	The status may be 'unknown' or 'entered-in-error', dependning on the type of message. status is required because of basic FHIR profile requirement 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.
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
priority	SΣ	0..1	code	Shall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5 Binding: MedComCareCommunicationRequestPriorityCodes (required)
medium		0..*	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	Focus of message
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
about		0..*	Reference(Resource)	Resources that pertain to this communication
encounter	SΣ	0..1	Reference(MedComCoreEncounter) {b}	Shall contain an encounter with a reference to the episodeOfCare-identifier if reported to the Danish National Patient Registry
sent		0..1	dateTime	When sent
received		0..1	dateTime	When received
recipient	S	0..*	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.
sender		0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why was communication done?
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a signature and a message text or attachment. At least one payload with a message text shall be included. Slice: Ordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
identifier	SΣ	0..1	MedComCareCommunicationAttachmentIdentifier	AttachmentIdentifierExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
payload:string	S	1..*	BackboneElement	xhtml content of the message
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	S	1..1	string	Message part content
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain all links or content attached to the message.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]	S	1..1	Attachment	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentAttachment	S	1..1	Attachment	Message part content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	0..1	code	The content type shall be present in case the content is provided as an attached document (data) or links to a document. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content if the attachment is an attached document
url	SΣ	0..1	url	Shall be present if the attachment is a link to a document or a web page Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	The time the attachment was created
note		0..*	Annotation	Comments made about the communication
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Communication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Communication.status	required	EventStatus
Communication.statusReason	example	CommunicationNotDoneReason
Communication.category	required	MedComCareCommunicationCategories
Communication.priority	required	MedComCareCommunicationRequestPriority
Communication.medium	example	ParticipationMode
Communication.topic	example	CommunicationTopic
Communication.reasonCode	example	SNOMEDCTClinicalFindings
Communication.payload:attachment.content[x]:contentAttachment.contentType	required	MedComCoreAttachmentMimeTypes
Communication.payload:attachment.content[x]:contentAttachment.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Differential View

This structure is derived from Communication

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver medcom-careCommunication-5: Priority is only allowed when Communication.category = 'regarding-referral' medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. medcom-careCommunication-9: When an attachment is included, it shall have an identifier medcom-careCommunication-10: The status shall be 'unknown' or 'entered-in-error'.
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
sender	SΣ	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-sender-extension
status	S	1..1	code	The status may be 'unknown' or 'entered-in-error', dependning on the type of message. status is required because of basic FHIR profile requirement
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
priority	S	0..1	code	Shall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5 Binding: MedComCareCommunicationRequestPriorityCodes (required)
subject	S	1..1	Reference(MedComCorePatient) {b}	Focus of message
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category.
encounter	S	0..1	Reference(MedComCoreEncounter) {b}	Shall contain an encounter with a reference to the episodeOfCare-identifier if reported to the Danish National Patient Registry
recipient	S	0..*	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a signature and a message text or attachment. At least one payload with a message text shall be included. Slice: Ordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
identifier	SΣ	0..1	MedComCareCommunicationAttachmentIdentifier	AttachmentIdentifierExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension
payload:string	S	1..*	BackboneElement	xhtml content of the message
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
content[x]	S	1..1	string	Message part content
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain all links or content attached to the message.
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
content[x]	S	1..1	Attachment	Message part content Slice: Unordered, Open by type:$this
contentAttachment	S	1..1	Attachment	Message part content
contentType	S	0..1	code	The content type shall be present in case the content is provided as an attached document (data) or links to a document. Binding: MedComCoreAttachmentMimeTypes (required)
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content if the attachment is an attached document
url	S	0..1	url	Shall be present if the attachment is a link to a document or a web page
title	S	1..1	string	Label to display in place of the data
creation	S	1..1	dateTime	The time the attachment was created
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Communication.category	required	MedComCareCommunicationCategories
Communication.priority	required	MedComCareCommunicationRequestPriority
Communication.payload:attachment.contentAttachment.contentType	required	MedComCoreAttachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-careCommunication-5	error	Communication	Priority is only allowed when Communication.category = 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	There shall exist a Communication.topic when Communication.category = 'other' : iif(category.coding.code != 'other', true, category.coding.code = 'other' and topic.exists())
medcom-careCommunication-7	error	Communication	There shall exist a practitioner role when using a PractitionerRole as author in a message segment. : payload.extension.value.reference.resolve().code.coding.code.exists()
medcom-careCommunication-8	error	Communication	There shall exist a practitioner name when using a Practitioner as author in a message segment. : payload.extension.value.reference.resolve().practitioner.resolve().name.exists()
medcom-careCommunication-9	error	Communication	When an attachment is included, it shall have an identifier : payload.where(content.data.exists()).extension('http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension').exists() or payload.content.data.exists().not()
medcom-careCommunication-10	error	Communication	The status shall be 'unknown' or 'entered-in-error'. : status='unknown' or status='entered-in-error'

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver medcom-careCommunication-5: Priority is only allowed when Communication.category = 'regarding-referral' medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. medcom-careCommunication-9: When an attachment is included, it shall have an identifier medcom-careCommunication-10: The status shall be 'unknown' or 'entered-in-error'.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
sender	SΣ	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-sender-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	The status may be 'unknown' or 'entered-in-error', dependning on the type of message. status is required because of basic FHIR profile requirement Binding: EventStatus (required): The status of the communication.
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
priority	SΣ	0..1	code	Shall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5 Binding: MedComCareCommunicationRequestPriorityCodes (required)
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	Focus of message
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
encounter	SΣ	0..1	Reference(MedComCoreEncounter) {b}	Shall contain an encounter with a reference to the episodeOfCare-identifier if reported to the Danish National Patient Registry
recipient	S	0..*	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a signature and a message text or attachment. At least one payload with a message text shall be included. Slice: Ordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
identifier	SΣ	0..1	MedComCareCommunicationAttachmentIdentifier	AttachmentIdentifierExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
payload:string	S	1..*	BackboneElement	xhtml content of the message
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	S	1..1	string	Message part content
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain all links or content attached to the message.
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]	S	1..1	Attachment	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentAttachment	S	1..1	Attachment	Message part content
contentType	SΣ	0..1	code	The content type shall be present in case the content is provided as an attached document (data) or links to a document. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content if the attachment is an attached document
url	SΣ	0..1	url	Shall be present if the attachment is a link to a document or a web page Example General: http://www.acme.com/logo-small.png
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	The time the attachment was created
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Communication.status	required	EventStatus
Communication.category	required	MedComCareCommunicationCategories
Communication.priority	required	MedComCareCommunicationRequestPriority
Communication.topic	example	CommunicationTopic
Communication.payload:attachment.content[x]:contentAttachment.contentType	required	MedComCoreAttachmentMimeTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
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()
medcom-careCommunication-5	error	Communication	Priority is only allowed when Communication.category = 'regarding-referral' : where(category.coding.code != 'regarding-referral').priority.empty()
medcom-careCommunication-6	error	Communication	There shall exist a Communication.topic when Communication.category = 'other' : iif(category.coding.code != 'other', true, category.coding.code = 'other' and topic.exists())
medcom-careCommunication-7	error	Communication	There shall exist a practitioner role when using a PractitionerRole as author in a message segment. : payload.extension.value.reference.resolve().code.coding.code.exists()
medcom-careCommunication-8	error	Communication	There shall exist a practitioner name when using a Practitioner as author in a message segment. : payload.extension.value.reference.resolve().practitioner.resolve().name.exists()
medcom-careCommunication-9	error	Communication	When an attachment is included, it shall have an identifier : payload.where(content.data.exists()).extension('http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension').exists() or payload.content.data.exists().not()
medcom-careCommunication-10	error	Communication	The status shall be 'unknown' or 'entered-in-error'. : status='unknown' or status='entered-in-error'

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Communication	C	0..*	Communication	A record of information transmitted from a sender to a receiver medcom-careCommunication-5: Priority is only allowed when Communication.category = 'regarding-referral' medcom-careCommunication-6: There shall exist a Communication.topic when Communication.category = 'other' medcom-careCommunication-7: There shall exist a practitioner role when using a PractitionerRole as author in a message segment. medcom-careCommunication-8: There shall exist a practitioner name when using a Practitioner as author in a message segment. medcom-careCommunication-9: When an attachment is included, it shall have an identifier medcom-careCommunication-10: The status shall be 'unknown' or 'entered-in-error'.
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
sender	SΣ	0..1	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	SenderExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-sender-extension
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(Resource)	Part of this action
inResponseTo		0..*	Reference(Communication)	Reply to
status	?!SΣ	1..1	code	The status may be 'unknown' or 'entered-in-error', dependning on the type of message. status is required because of basic FHIR profile requirement 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.
category	S	1..1	CodeableConcept	The category (Danish: kategori) describes the overall content of the message. Binding: MedComCareCommunicationCategoryCodes (required)
priority	SΣ	0..1	code	Shall be present if the message priority is known to be ASAP, but is only allowed when the category is 'regarding referral', see medcom-careCommunication-5 Binding: MedComCareCommunicationRequestPriorityCodes (required)
medium		0..*	CodeableConcept	A channel of communication Binding: ParticipationMode (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject	SΣ	1..1	Reference(MedComCorePatient) {b}	Focus of message
topic	S	0..1	CodeableConcept	The topic (Danish: emne) may be added as a supplement to the category. Binding: CommunicationTopic (example): Codes describing the purpose or content of the communication.
about		0..*	Reference(Resource)	Resources that pertain to this communication
encounter	SΣ	0..1	Reference(MedComCoreEncounter) {b}	Shall contain an encounter with a reference to the episodeOfCare-identifier if reported to the Danish National Patient Registry
sent		0..1	dateTime	When sent
received		0..1	dateTime	When received
recipient	S	0..*	Reference(MedComCorePractitionerRole | MedComCoreCareTeam) {b}	Describes a more specific receiver than the MessageHeader.destination.reciever, called a recipient. It may be a careteam a homecare group in the municipality or a named general practitioner.
sender		0..1	Reference(Device | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson | HealthcareService)	Message sender
reasonCode	Σ	0..*	CodeableConcept	Indication for message Binding: SNOMEDCTClinicalFindings (example): Codes for describing reasons for the occurrence of a communication.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Why was communication done?
Slices for payload		1..*	BackboneElement	Each payload corresponds to a message segment with a signature and a message text or attachment. At least one payload with a message text shall be included. Slice: Ordered, Open by type:$this.content
payload:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
identifier	SΣ	0..1	MedComCareCommunicationAttachmentIdentifier	AttachmentIdentifierExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]		1..1		Message part content
contentString			string
contentAttachment			Attachment
contentReference			Reference(Resource)
payload:string	S	1..*	BackboneElement	xhtml content of the message
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
content[x]	S	1..1	string	Message part content
payload:attachment	S	0..*	BackboneElement	The payload with an attachment shall contain all links or content attached to the message.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	PayloadDateTimeExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
author	SΣ	1..1	Reference(MedComCorePractitionerRole) {b}	PayloadAuthorExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
authorContact	SΣ	1..1	ContactPoint	PayloadAuthorContactExtension URL: http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for content[x]	S	1..1	Attachment	Message part content Slice: Unordered, Closed by type:$this
content[x]:contentAttachment	S	1..1	Attachment	Message part content
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	0..1	code	The content type shall be present in case the content is provided as an attached document (data) or links to a document. Binding: MedComCoreAttachmentMimeTypes (required) Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	0..1	base64Binary	Shall be present and contain the base64 encoded content if the attachment is an attached document
url	SΣ	0..1	url	Shall be present if the attachment is a link to a document or a web page Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	SΣ	1..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	SΣ	1..1	dateTime	The time the attachment was created
note		0..*	Annotation	Comments made about the communication
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Communication.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Communication.status	required	EventStatus
Communication.statusReason	example	CommunicationNotDoneReason
Communication.category	required	MedComCareCommunicationCategories
Communication.priority	required	MedComCareCommunicationRequestPriority
Communication.medium	example	ParticipationMode
Communication.topic	example	CommunicationTopic
Communication.reasonCode	example	SNOMEDCTClinicalFindings
Communication.payload:attachment.content[x]:contentAttachment.contentType	required	MedComCoreAttachmentMimeTypes
Communication.payload:attachment.content[x]:contentAttachment.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

This structure is derived from Communication

Summary

Mandatory: 10 elements (6 nested mandatory elements)
Must-Support: 28 elements

Structures

This structure refers to these other structures:

• MedComCorePatient (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-patient)
• MedComCoreEncounter (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-encounter)
• MedComCorePractitionerRole (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-practitionerrole)
• MedComCoreCareTeam (http://medcomfhir.dk/ig/core/StructureDefinition/medcom-core-careteam)

Extensions

This structure refers to these extensions:

• http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-sender-extension
• http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-datetime-extension
• http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-extension
• http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-author-contact-extension
• http://medcomfhir.dk/ig/carecommunication/StructureDefinition/medcom-carecommunication-attachment-identifier-extension

Slices

This structure defines the following Slices:

• The element Communication.payload is sliced based on the value of type:$this.content (ordered)
• The element Communication.payload.content[x] is sliced based on the value of type:$this