Generated Narrative: StructureDefinition medcom-messaging-messagedefinition Name Flags Card. Type Description & Constraints MessageDefinition 0..* MessageDefinition A resource that defines a type of message that can be exchanged between systems identifier S 1..1 Identifier Primary key for the message definition on a given server use S 1..1 code usual | official | temp | secondary | old (If known) type S 1..1 CodeableConcept Description of identifier Binding: MedComMessageDefinitionTypeValueset (required) coding system 0..1 uri Identity of the terminology system Required Pattern: http://medcomfhir.dk/ig/terminology/CodeSystem/medcom-message-definition-type system 1..1 uri The namespace for the identifier value Binding: MessageDefinitionIdentifierSystemValueset (required) value S 1..1 string The value that is unique period start S 1..1 dateTime Starting time with inclusive boundary end S 0..1 dateTime End time with inclusive boundary, if not ongoing version S 1..1 string Business version of the message definition title S 1..1 string Name for this message definition (human friendly) replaces value S 0..1 string Primitive value for canonical publisher S 1..1 string Name of the publisher (organization or individual) Required Pattern: MedCom, https://www.medcom.dk Slices for contact S 0..* ContactDetail Contact details for the publisher Slice: Unordered, Open by value:id contact:InteroperabilityConsultant S 0..1 ContactDetail Contact details for the publisher id S 1..1 string Unique id for inter-element referencing Required Pattern: InteroperabilityConsultant name S 1..1 string Name of an individual to contact telecom system S 1..1 code phone | fax | email | pager | url | sms | other Fixed Value: email value S 1..1 string The actual contact point details use S 1..1 code home | work | temp | old | mobile - purpose of this contact point Fixed Value: work contact:SubjectMatterExpert S 0..1 ContactDetail Contact details for the publisher id S 1..1 string Unique id for inter-element referencing Required Pattern: SubjectMatterExpert name S 1..1 string Name of an individual to contact telecom system S 1..1 code phone | fax | email | pager | url | sms | other Fixed Value: email value S 1..1 string The actual contact point details use S 1..1 code home | work | temp | old | mobile - purpose of this contact point Fixed Value: work useContext code 1..1 Coding Type of context being specified Binding: UseContextCodeSystemValueset (required) system 0..1 uri Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/usage-context-type jurisdiction S 1..1 CodeableConcept Intended jurisdiction for message definition (if applicable) Required Pattern: At least the following coding 1..* Coding Code defined by a terminology system Fixed Value: (complex) code 1..1 code Symbol in syntax defined by the system Fixed Value: DK category S 1..1 code consequence | currency | notification Fixed Value: notification responseRequired S 1..1 code always | on-error | never | on-success Documentation for this format
An example profile of the MessageDefinition resource.
A resource that defines a type of message that can be exchanged between systems
Defines the characteristics of a message that can be shared between systems, including the type of event that initiates the message, the content to be transmitted and what response(s), if any, are permitted.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
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
Name should be usable as an identifier for the module by machine processing applications such as code generation
not(exists(f:name/@value)) or matches(f:name/@value, '[A-Z]([A-Za-z0-9_]){0,254}')
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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 it's 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 it's 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 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, and nor can they have their own independent transaction scope.
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.
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Business Identifier for a given MessageDefinition
The business identifier that is used to reference the MessageDefinition and *is* expected to be consistent from server to server.
Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version. The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](http://hl7.org/fhir/R4/resource.html#versions). In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](http://hl7.org/fhir/R4/resource.html#meta) element to indicate where the current master source of the resource can be found.
Allows the message definition to be referenced by a single globally unique identifier.
Primary key for the message definition on a given server
A formal identifier that is used to identify this message definition when it is represented in other formats, or referenced in a specification, model, design or an instance.
Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this message definition outside of FHIR, where it is not possible to use the logical URI.
Allows externally provided and/or usable business identifiers to be easily associated with the module.
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
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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 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 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
Establishes the namespace for the value - that is, a 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 [Rendered Value extension](http://hl7.org/fhir/R4/extension-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
The start of the period. The boundary is inclusive.
If the low element is missing, the meaning is that the low boundary is not known.
End time with inclusive boundary, if not ongoing
The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
If the end of the period is missing, it means that the period is ongoing
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
Business version of the message definition
The identifier that is used to identify this version of the message definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the message definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.
There may be different message definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the message definition with the format [url]|[version].
Name for this message definition (computer friendly)
A natural language name identifying the message definition. This name should be usable as an identifier for the module by machine processing applications such as code generation.
The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
Support human navigation and code generation.
Name for this message definition (human friendly)
A short, descriptive, user-friendly title for the message definition.
This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
A MessageDefinition that is superseded by this definition.
unique id for the element within a resource (for internal references)
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
The status of this message definition. Enables tracking the life-cycle of the content.
Allows filtering of message definitions that are appropriate for use versus not.
This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
A Boolean value to indicate that this message definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
Enables experimental content to be developed following the same lifecycle that would be used for a production-level message definition.
The date (and optionally time) when the message definition was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the message definition changes.
Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the message definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
Name of the publisher (organization or individual)
The name of the organization or individual that published the message definition.
Usually an organization but may be an individual. The publisher (or steward) of the message definition is the organization or individual primarily responsible for the maintenance and upkeep of the message definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the message definition. This item SHOULD be populated unless the information is available from context.
Helps establish the "authority/credibility" of the message definition. May also allow for contact.
Contact details to assist a user in finding and communicating with the publisher.
May be a web site, an email address, a telephone number, etc.
If there is no named individual, the telecom information is for the organization as a whole.
Contact details for individual or organization
The contact details for the individual (if a name was provided) or the organization.
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.
Time period when the contact point was/is in use
Time period when the contact point was/is in use.
Natural language description of the message definition
A free text natural language description of the message definition from a consumer's perspective.
This description can be used to capture details such as why the message definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the message definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the message definition is presumed to be the predominant language in the place the message definition was created).
The context that the content is intended to support
The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate message definition instances.
When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Assist in searching for appropriate content.
A code that identifies the type of context being specified by this usage context.
A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.
A code that defines the specific value for the context being specified.
Intended jurisdiction for message definition (if applicable)
A legal or geographic region in which the message definition is intended to be used.
It may be possible for the message definition to be used in jurisdictions other than those for which it was originally designed or intended.
Countries and regions within which this artifact is targeted for use.
Explanation of why this message definition is needed and why it has been designed as it has.
This element does not describe the usage of the message definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this message definition.
A copyright statement relating to the message definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the message definition.
Consumers must be able to determine any legal restrictions on the use of the message definition and/or its content.
The MessageDefinition that is the basis for the contents of this resource.
Identifies a protocol or workflow that this MessageDefinition represents a step in.
It should be possible to use MessageDefinition to describe a message to be used by certain steps in a particular protocol as part of a PlanDefinition or ActivityDefinition.
Event code or link to the EventDefinition
Event code or link to the EventDefinition.
One of the message events defined as part of this version of FHIR.
The impact of the content of the message.
Resource(s) that are the subject of the event
Identifies the resource (or resources) that are being addressed by the event. For example, the Encounter for an admit message or two Account records for a merge.
f:max/@value='*' or number(f:max/@value) > 0
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
The kind of resource that must be the focus for this message.
Multiple focuses addressing different resources may occasionally occur. E.g. to link or unlink a resource from a particular account or encounter, etc.
One of the resource types defined as part of this version of FHIR.
Profile that must be adhered to by focus
A profile that reflects constraints for the focal resource (and potentially for related resources).
This should be present for most message definitions. However, if the message focus is only a single resource and there is no need to include referenced resources or otherwise enforce the presence of particular elements, it can be omitted.
This profile allows setting boundaries for what content must appear within the message bundle vs. outside based on the declared aggregation constraints on referenced resources on this and related profiles.
Identifies the minimum number of resources of this type that must be pointed to by a message in order for it to be valid against this MessageDefinition.
Identifies the maximum number of resources of this type that must be pointed to by a message in order for it to be valid against this MessageDefinition.
Declare at a message definition level whether a response is required or only upon error or success, or never.
This enables the capability currently available through MSH-16 (Application Level acknowledgement) in HL7 Version 2 to declare at a message instance level whether a response is required or only upon error or success, or never.
HL7-defined table of codes which identify conditions under which acknowledgments are required to be returned in response to a message.
Indicates what types of messages may be sent as an application-level response to this message.
This indicates an application level response to "close" a transaction implicit in a particular request message. To define a complete workflow scenario, look to the PlanDefinition resource which allows the definition of complex orchestrations, conditionality, etc.
Reference to allowed message definition response
A reference to the message definition that must be adhered to by this supported response.
Provides a description of the circumstances in which this response should be used (as opposed to one of the alternative responses).
Canonical reference to a GraphDefinition
Canonical reference to a GraphDefinition. If a URL is provided, it is the canonical reference to a [GraphDefinition](graphdefinition.html) that it controls what resources are to be added to the bundle when building the document. The GraphDefinition can also specify profiles that apply to the various resources.