IE (Ireland) Core Implementation Guide
1.0.0-ballot - Ballot Ireland flag

Publication Build: This will be filled in by the publication tooling

Resource Profile: IECorePractitionerProfile - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 3

Definitions for the ie-core-practitioner resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Practitioner
Must Supportfalse
Alternate NamesProvider
2. Practitioner.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
TypeIdentifier(IE Core Irish Medical Council)
Must Supporttrue
SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ system
  • 4. Practitioner.identifier:IMC
    Slice NameIMC
    Definition

    Irish Medical Council (IMC) registeration number assigned to a doctor.

    ShortIrish Medical Council (IMC)
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    This element is affected by the following invariants: ie-core-ihi-0
    Must Supporttrue
    6. Practitioner.name
    Control1..?
    Must Supporttrue
    8. Practitioner.name.family
    Control1..?
    Must Supporttrue
    10. Practitioner.telecom
    Must Supporttrue
    12. Practitioner.telecom.system
    Must Supporttrue
    14. Practitioner.telecom.value
    Must Supporttrue
    16. Practitioner.address
    Definition

    Address(es) of the practitioner

    ShortAddress(es) of the practitioner
    Must Supporttrue
    Requirements

    -

    18. Practitioner.address.line
    Must Supporttrue
    Example<br/><b>General</b>:51 Bracken Rd
    20. Practitioner.address.city
    Must Supporttrue
    Example<br/><b>General</b>:Sandyford
    22. Practitioner.address.state
    BindingUnless not suitable, these codes SHALL be taken from Ireland Counties
    (extensible to http://iehr.ai/fhir/ie/core/ValueSet/ie-core-counties)

    County

    Must Supporttrue
    Example<br/><b>General</b>:Dublin
    24. Practitioner.address.postalCode
    ShortIE Eircodes
    Must Supporttrue
    Example<br/><b>General</b>:D18 CV48
    26. Practitioner.address.country
    Must Supporttrue

    Guidance on how to interpret the contents of this table can be found here

    0. Practitioner
    Definition

    A person who is directly or indirectly involved in the provisioning of healthcare.

    ShortA person with a formal responsibility in the provisioning of healthcare or related services
    Control0..*
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Alternate NamesProvider
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. Practitioner.implicitRules
    Definition

    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.

    ShortA set of rules under which this content was created
    Comments

    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.

    Control0..1
    Typeuri
    Is Modifiertrue because 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
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. Practitioner.modifierExtension
    Definition

    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).

    ShortExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    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.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    6. Practitioner.identifier
    Definition

    An identifier that applies to this person in this role.

    ShortAn identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier(IE Core Irish Medical Council)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ system
    • 8. Practitioner.identifier:IMC
      Slice NameIMC
      Definition

      Irish Medical Council (IMC) registeration number assigned to a doctor.


      An identifier that applies to this person in this role.

      ShortIrish Medical Council (IMC)An identifier for the person as this agent
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1*
      This element is affected by the following invariants: ie-core-ihi-0
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Often, specific identities are assigned for the agent.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Practitioner.name
      Definition

      The name(s) associated with the practitioner.

      ShortThe name(s) associated with the practitioner
      Comments

      The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

      In general, select the value to be used in the ResourceReference.display based on this:

      1. There is more than 1 name
      2. Use = usual
      3. Period is current to the date of the usage
      4. Use = official
      5. Other order as decided by internal business rules.
      Control10..*
      TypeHumanName
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Practitioner.name.use
      Definition

      Identifies the purpose for this name.

      Shortusual | official | temp | nickname | anonymous | old | maiden
      Comments

      Applications can assume that a name is current unless it explicitly says that it is temporary or old.

      Control0..1
      BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

      The use of a human name.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows the appropriate name for a particular context of use to be selected from among a set of names.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Practitioner.name.family
      Definition

      The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

      ShortFamily name (often called 'Surname')
      Comments

      Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate Namessurname
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Practitioner.telecom
      Definition

      A contact detail for the practitioner, e.g. a telephone number or an email address.

      ShortA contact detail for the practitioner (that apply to all roles)
      Comments

      Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.

      Control0..*
      TypeContactPoint
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Need to know how to reach a practitioner independent to any roles the practitioner may have.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Practitioner.telecom.system
      Definition

      Telecommunications form for contact point - what communications system is required to make use of the contact.

      Shortphone | fax | email | pager | url | sms | other
      Control0..1
      This element is affected by the following invariants: cpt-2
      BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
      (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

      Telecommunications form for contact point.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Practitioner.telecom.value
      Definition

      The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

      ShortThe actual contact point details
      Comments

      Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      Need to support legacy numbers that are not in a tightly controlled format.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Practitioner.telecom.use
      Definition

      Identifies the purpose for the contact point.

      Shorthome | work | temp | old | mobile - purpose of this contact point
      Comments

      Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

      Control0..1
      BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

      Use of contact point.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Practitioner.address
      Definition

      Address(es) of the practitioner


      Address(es) of the practitioner that are not role specific (typically home address). Work addresses are not typically entered in this property as they are usually role dependent.

      ShortAddress(es) of the practitionerAddress(es) of the practitioner that are not role specific (typically home address)
      Comments

      The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

      Control0..*
      TypeAddress
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      -


      The home/mailing address of the practitioner is often required for employee administration purposes, and also for some rostering services where the start point (practitioners home) can be used in calculations.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Practitioner.address.use
      Definition

      The purpose of this address.

      Shorthome | work | temp | old | billing - purpose of this address
      Comments

      Applications can assume that an address is current unless it explicitly says that it is temporary or old.

      Control0..1
      BindingThe codes SHALL be taken from AddressUsehttp://hl7.org/fhir/ValueSet/address-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

      The use of an address.

      Typecode
      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Allows an appropriate address to be chosen from a list of many.

      Example<br/><b>General</b>:home
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Practitioner.address.line
      Definition

      This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

      ShortStreet name, number, direction & P.O. Box etc.
      Control0..*
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Example<br/><b>General</b>:137 Nowhere Street <br/><b>General</b>:51 Bracken Rd
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Practitioner.address.city
      Definition

      The name of the city, town, suburb, village or other community or delivery center.

      ShortName of city, town etc.
      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate NamesMunicpality
      Example<br/><b>General</b>:Erewhon <br/><b>General</b>:Sandyford
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Practitioner.address.state
      Definition

      Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

      ShortSub-unit of country (abbreviations ok)
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For codes, see Ireland Counties
      (extensible to http://iehr.ai/fhir/ie/core/ValueSet/ie-core-counties)

      County

      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate NamesProvince, Territory
      Example<br/><b>General</b>:Dublin
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Practitioner.address.postalCode
      Definition

      A postal code designating a region defined by the postal service.

      ShortIE EircodesPostal code for area
      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Alternate NamesZip
      Example<br/><b>General</b>:9132 <br/><b>General</b>:D18 CV48
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Practitioner.address.country
      Definition

      Country - a nation as commonly understood or generally accepted.

      ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
      Comments

      ISO 3166 3 letter codes can be used in place of a human readable country name.

      Control0..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. Practitioner
      Definition

      A person who is directly or indirectly involved in the provisioning of healthcare.

      ShortA person with a formal responsibility in the provisioning of healthcare or related services
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate NamesProvider
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Practitioner.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Practitioner.meta
      Definition

      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.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Practitioner.implicitRules
      Definition

      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.

      ShortA set of rules under which this content was created
      Comments

      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.

      Control0..1
      Typeuri
      Is Modifiertrue because 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
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Practitioner.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      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).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Practitioner.text
      Definition

      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.

      ShortText summary of the resource, for human interpretation
      Comments

      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.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Practitioner.contained
      Definition

      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.

      ShortContained, inline Resources
      Comments

      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.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Practitioner.extension
      Definition

      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.

      ShortAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. Practitioner.modifierExtension
      Definition

      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).

      ShortExtensions that cannot be ignored
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      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.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. Practitioner.identifier
      Definition

      An identifier that applies to this person in this role.

      ShortAn identifier for the person as this agent
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier(IE Core Irish Medical Council)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Often, specific identities are assigned for the agent.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • pattern @ system
      • 20. Practitioner.identifier:IMC
        Slice NameIMC
        Definition

        Irish Medical Council (IMC) registeration number assigned to a doctor.

        ShortIrish Medical Council (IMC)
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        This element is affected by the following invariants: ie-core-ihi-0
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Often, specific identities are assigned for the agent.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Practitioner.active
        Definition

        Whether this practitioner's record is in active use.

        ShortWhether this practitioner's record is in active use
        Comments

        If the practitioner is not in use by one organization, then it should mark the period on the PractitonerRole with an end date (even if they are active) as they may be active in another role.

        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be able to mark a practitioner record as not to be used because it was created in error.

        Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Practitioner.name
        Definition

        The name(s) associated with the practitioner.

        ShortThe name(s) associated with the practitioner
        Comments

        The selection of the use property should ensure that there is a single usual name specified, and others use the nickname (alias), old, or other values as appropriate.

        In general, select the value to be used in the ResourceReference.display based on this:

        1. There is more than 1 name
        2. Use = usual
        3. Period is current to the date of the usage
        4. Use = official
        5. Other order as decided by internal business rules.
        Control1..*
        TypeHumanName
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        The name(s) that a Practitioner is known by. Where there are multiple, the name that the practitioner is usually known as should be used in the display.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Practitioner.name.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        28. Practitioner.name.extension
        Definition

        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Practitioner.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 30. Practitioner.name.use
          Definition

          Identifies the purpose for this name.

          Shortusual | official | temp | nickname | anonymous | old | maiden
          Comments

          Applications can assume that a name is current unless it explicitly says that it is temporary or old.

          Control0..1
          BindingThe codes SHALL be taken from NameUse
          (required to http://hl7.org/fhir/ValueSet/name-use|4.0.1)

          The use of a human name.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the appropriate name for a particular context of use to be selected from among a set of names.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Practitioner.name.text
          Definition

          Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

          ShortText representation of the full name
          Comments

          Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          A renderable, unencoded form.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Practitioner.name.family
          Definition

          The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

          ShortFamily name (often called 'Surname')
          Comments

          Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Alternate Namessurname
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Practitioner.name.given
          Definition

          Given name.

          ShortGiven names (not always 'first'). Includes middle names
          Comments

          If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

          Control0..*
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate Namesfirst name, middle name
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Practitioner.name.prefix
          Definition

          Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

          ShortParts that come before the name
          Control0..*
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Practitioner.name.suffix
          Definition

          Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

          ShortParts that come after the name
          Control0..*
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          42. Practitioner.name.period
          Definition

          Indicates the period of time when this name was valid for the named person.

          ShortTime period when name was/is in use
          Control0..1
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows names to be placed in historical context.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. Practitioner.telecom
          Definition

          A contact detail for the practitioner, e.g. a telephone number or an email address.

          ShortA contact detail for the practitioner (that apply to all roles)
          Comments

          Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently and to help with identification. These typically will have home numbers, or mobile numbers that are not role specific.

          Control0..*
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Need to know how to reach a practitioner independent to any roles the practitioner may have.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          46. Practitioner.telecom.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          48. Practitioner.telecom.extension
          Definition

          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.

          ShortAdditional content defined by implementations
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Practitioner.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 50. Practitioner.telecom.system
            Definition

            Telecommunications form for contact point - what communications system is required to make use of the contact.

            Shortphone | fax | email | pager | url | sms | other
            Control0..1
            This element is affected by the following invariants: cpt-2
            BindingThe codes SHALL be taken from ContactPointSystem
            (required to http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1)

            Telecommunications form for contact point.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Practitioner.telecom.value
            Definition

            The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

            ShortThe actual contact point details
            Comments

            Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Need to support legacy numbers that are not in a tightly controlled format.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Practitioner.telecom.use
            Definition

            Identifies the purpose for the contact point.

            Shorthome | work | temp | old | mobile - purpose of this contact point
            Comments

            Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

            Control0..1
            BindingThe codes SHALL be taken from ContactPointUse
            (required to http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1)

            Use of contact point.

            Typecode
            Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Practitioner.telecom.rank
            Definition

            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.

            ShortSpecify preferred order of use (1 = highest)
            Comments

            Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

            Control0..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Practitioner.telecom.period
            Definition

            Time period when the contact point was/is in use.

            ShortTime period when the contact point was/is in use
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Practitioner.address
            Definition

            Address(es) of the practitioner

            ShortAddress(es) of the practitioner
            Comments

            The PractitionerRole does not have an address value on it, as it is expected that the location property be used for this purpose (which has an address).

            Control0..*
            TypeAddress
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            -

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. Practitioner.address.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            64. Practitioner.address.extension
            Definition

            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.

            ShortAdditional content defined by implementations
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Practitioner.address.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 66. Practitioner.address.use
              Definition

              The purpose of this address.

              Shorthome | work | temp | old | billing - purpose of this address
              Comments

              Applications can assume that an address is current unless it explicitly says that it is temporary or old.

              Control0..1
              BindingThe codes SHALL be taken from AddressUse
              (required to http://hl7.org/fhir/ValueSet/address-use|4.0.1)

              The use of an address.

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Allows an appropriate address to be chosen from a list of many.

              Example<br/><b>General</b>:home
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. Practitioner.address.type
              Definition

              Distinguishes between physical addresses (those you can visit) and mailing addresses (e.g. PO Boxes and care-of addresses). Most addresses are both.

              Shortpostal | physical | both
              Comments

              The definition of Address states that "address is intended to describe postal addresses, not physical locations". However, many applications track whether an address has a dual purpose of being a location that can be visited as well as being a valid delivery destination, and Postal addresses are often used as proxies for physical locations (also see the Location resource).

              Control0..1
              BindingThe codes SHALL be taken from AddressType
              (required to http://hl7.org/fhir/ValueSet/address-type|4.0.1)

              The type of an address (physical / postal).

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Example<br/><b>General</b>:both
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. Practitioner.address.text
              Definition

              Specifies the entire address as it should be displayed e.g. on a postal label. This may be provided instead of or as well as the specific parts.

              ShortText representation of the address
              Comments

              Can provide both a text representation and parts. Applications updating an address SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              A renderable, unencoded form.

              Example<br/><b>General</b>:137 Nowhere Street, Erewhon 9132
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. Practitioner.address.line
              Definition

              This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

              ShortStreet name, number, direction & P.O. Box etc.
              Control0..*
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Example<br/><b>General</b>:137 Nowhere Street <br/><b>General</b>:51 Bracken Rd
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. Practitioner.address.city
              Definition

              The name of the city, town, suburb, village or other community or delivery center.

              ShortName of city, town etc.
              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Alternate NamesMunicpality
              Example<br/><b>General</b>:Erewhon <br/><b>General</b>:Sandyford
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Practitioner.address.district
              Definition

              The name of the administrative area (county).

              ShortDistrict name (aka county)
              Comments

              District is sometimes known as county, but in some regions 'county' is used in place of city (municipality), so county name should be conveyed in city instead.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Alternate NamesCounty
              Example<br/><b>General</b>:Madison
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Practitioner.address.state
              Definition

              Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

              ShortSub-unit of country (abbreviations ok)
              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from Ireland Counties
              (extensible to http://iehr.ai/fhir/ie/core/ValueSet/ie-core-counties)

              County

              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Alternate NamesProvince, Territory
              Example<br/><b>General</b>:Dublin
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. Practitioner.address.postalCode
              Definition

              A postal code designating a region defined by the postal service.

              ShortIE Eircodes
              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Alternate NamesZip
              Example<br/><b>General</b>:9132 <br/><b>General</b>:D18 CV48
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. Practitioner.address.country
              Definition

              Country - a nation as commonly understood or generally accepted.

              ShortCountry (e.g. can be ISO 3166 2 or 3 letter code)
              Comments

              ISO 3166 3 letter codes can be used in place of a human readable country name.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              84. Practitioner.address.period
              Definition

              Time period when address was/is in use.

              ShortTime period when address was/is in use
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows addresses to be placed in historical context.

              Example<br/><b>General</b>:{ "start" : "2010-03-23", "end" : "2010-07-01" }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. Practitioner.gender
              Definition

              Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

              Shortmale | female | other | unknown
              Control0..1
              BindingThe codes SHALL be taken from AdministrativeGender
              (required to http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1)

              The gender of a person used for administrative purposes.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Needed to address the person correctly.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              88. Practitioner.birthDate
              Definition

              The date of birth for the practitioner.

              ShortThe date on which the practitioner was born
              Control0..1
              Typedate
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Needed for identification.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. Practitioner.photo
              Definition

              Image of the person.

              ShortImage of the person
              Control0..*
              TypeAttachment
              Is Modifierfalse
              Summaryfalse
              Requirements

              Many EHR systems have the capability to capture an image of patients and personnel. Fits with newer social media usage too.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              92. Practitioner.qualification
              Definition

              The official certifications, training, and licenses that authorize or otherwise pertain to the provision of care by the practitioner. For example, a medical license issued by a medical board authorizing the practitioner to practice medicine within a certian locality.

              ShortCertification, licenses, or training pertaining to the provision of care
              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              94. Practitioner.qualification.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              96. Practitioner.qualification.extension
              Definition

              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.

              ShortAdditional content defined by implementations
              Comments

              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.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              98. Practitioner.qualification.modifierExtension
              Definition

              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).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              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.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              100. Practitioner.qualification.identifier
              Definition

              An identifier that applies to this person's qualification in this role.

              ShortAn identifier for this qualification for the practitioner
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier
              Is Modifierfalse
              Summaryfalse
              Requirements

              Often, specific identities are assigned for the qualification.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              102. Practitioner.qualification.code
              Definition

              Coded representation of the qualification.

              ShortCoded representation of the qualification
              Control1..1
              BindingFor example codes, see v2 table 0360, Version 2.7
              (example to http://terminology.hl7.org/ValueSet/v2-2.7-0360)

              Specific qualification the practitioner has to provide a service.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              104. Practitioner.qualification.period
              Definition

              Period during which the qualification is valid.

              ShortPeriod during which the qualification is valid
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summaryfalse
              Requirements

              Qualifications are often for a limited period of time, and can be revoked.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              106. Practitioner.qualification.issuer
              Definition

              Organization that regulates and issues the qualification.

              ShortOrganization that regulates and issues the qualification
              Control0..1
              TypeReference(Organization)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              108. Practitioner.communication
              Definition

              A language the practitioner can use in patient communication.

              ShortA language the practitioner can use in patient communication
              Comments

              The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

              Control0..*
              BindingThe codes SHOULD be taken from CommonLanguages
              (preferred to http://hl7.org/fhir/ValueSet/languages)

              A human language.

              Additional BindingsPurpose
              AllLanguagesMax Binding
              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Knowing which language a practitioner speaks can help in facilitating communication with patients.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))