FHIR IG Statistics: StructureDefinition/cyehr-sd-consenthealthcareassociate-r4

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{
  "resourceType": "StructureDefinition",
  "id": "cyehr-sd-consenthealthcareassociate-r4",
  "url": "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-consenthealthcareassociate-r4",
  "name": "CYEHRSDConsentHealthcareAssociate",
  "title": "Cyprus EHR Healthcare Associate Consent profile",
  "status": "draft",
  "publisher": "eHealth4U",
  "contact": [
    {
      "name": "eHealth Lab (University of Cyprus)",
      "telecom": [
        {
          "system": "email",
          "value": "ehealthl@ucy.ac.cy",
          "use": "work"
        }
      ]
    }
  ],
  "description": "The main use-case of this profile is to indicate that a Patient has agreed and has authorized a medical doctor to gain access to his/her national EHR health data. Other healthcare associate practitioners who belong to the medical doctor's medical team (via their practitioner roles) can also be added as actors of the consent. A healthcare associate practitioner shall be able to access a patient's EHR data if and only if there is an acitve consent linking the Patient and the Practitioner (via a specific practitioner role of the practitioner).",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Consent",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Consent",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Consent.meta",
        "path": "Consent.meta"
      },
      {
        "id": "Consent.meta.profile",
        "path": "Consent.meta.profile",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Consent.meta.profile:CyprusEHRProfile",
        "path": "Consent.meta.profile",
        "sliceName": "CyprusEHRProfile",
        "min": 1,
        "max": "1",
        "fixedCanonical": "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-consenthealthcareassociate-r4"
      },
      {
        "id": "Consent.identifier",
        "path": "Consent.identifier",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "mustSupport": true
      },
      {
        "id": "Consent.identifier.system",
        "path": "Consent.identifier.system",
        "min": 1
      },
      {
        "id": "Consent.identifier.value",
        "path": "Consent.identifier.value",
        "min": 1
      },
      {
        "id": "Consent.identifier:healthcareProviderNeHAConsent",
        "path": "Consent.identifier",
        "sliceName": "healthcareProviderNeHAConsent",
        "max": "1",
        "patternIdentifier": {
          "use": "official",
          "system": "urn:oid:2.16.840.1.113883.3.9143.5.2.1"
        },
        "mustSupport": true
      },
      {
        "id": "Consent.identifier:healthcareProviderNeHAConsent.system",
        "path": "Consent.identifier.system",
        "min": 1
      },
      {
        "id": "Consent.identifier:healthcareProviderNeHAConsent.value",
        "path": "Consent.identifier.value",
        "definition": "The portion of the identifier typically relevant to the user and which is unique within the context of the system.\r\n\r\nCyprusEHR: A globally unique number assigned by the national integrated EHR system of Cyprus to each consent provided by the patient to a healthcare provider.",
        "min": 1
      },
      {
        "id": "Consent.status",
        "path": "Consent.status",
        "comment": "This element is labeled as a modifier because the status contains the codes rejected and entered-in-error that mark the Consent as not currently valid.\r\n\r\nCyprusEHR: Can be either active (meaning that the consent can be used) or inactive (meaning that the consent was revoked either by the patient or because it is expired)",
        "mustSupport": true
      },
      {
        "id": "Consent.scope",
        "path": "Consent.scope",
        "type": [
          {
            "code": "CodeableConcept",
            "profile": [
              "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips"
            ]
          }
        ],
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/consentscope",
              "code": "patient-privacy"
            }
          ]
        }
      },
      {
        "id": "Consent.scope.coding",
        "path": "Consent.scope.coding",
        "min": 1
      },
      {
        "id": "Consent.scope.coding.system",
        "path": "Consent.scope.coding.system",
        "min": 1
      },
      {
        "id": "Consent.scope.coding.code",
        "path": "Consent.scope.coding.code",
        "min": 1
      },
      {
        "id": "Consent.scope.coding.display",
        "path": "Consent.scope.coding.display",
        "min": 1
      },
      {
        "id": "Consent.category",
        "path": "Consent.category",
        "type": [
          {
            "code": "CodeableConcept",
            "profile": [
              "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips"
            ]
          }
        ],
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "INFA"
            }
          ]
        }
      },
      {
        "id": "Consent.category.coding",
        "path": "Consent.category.coding",
        "min": 1
      },
      {
        "id": "Consent.category.coding.system",
        "path": "Consent.category.coding.system",
        "min": 1
      },
      {
        "id": "Consent.category.coding.code",
        "path": "Consent.category.coding.code",
        "min": 1
      },
      {
        "id": "Consent.category.coding.display",
        "path": "Consent.category.coding.display",
        "min": 1
      },
      {
        "id": "Consent.patient",
        "path": "Consent.patient",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-patient"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.patient.reference",
        "path": "Consent.patient.reference",
        "min": 1
      },
      {
        "id": "Consent.dateTime",
        "path": "Consent.dateTime",
        "mustSupport": true
      },
      {
        "id": "Consent.performer",
        "path": "Consent.performer",
        "comment": "Commonly, the patient the consent pertains to is the consentor, but particularly for young and old people, it may be some other person - e.g. a legal guardian.\r\n\r\nCyprusEHR: Reference the practitionerrole of the doctor that was granted with the consent, his/her medical team  and either the Patient or the patient's legal representatives who granted the consent.",
        "min": 2,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-patient",
              "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-medicalteam-r4",
              "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-practitionerrolehealthcareassociate-r4"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.performer.reference",
        "path": "Consent.performer.reference",
        "min": 1
      },
      {
        "id": "Consent.organization",
        "path": "Consent.organization",
        "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.\r\n\r\nCyprusEHR: The organization that manages the consent and the framework within which it is executed is the National eHealth Authority for the national integrated EHR of Cyprus.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-organization-r4"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Consent.organization.reference",
        "path": "Consent.organization.reference",
        "min": 1
      },
      {
        "id": "Consent.source[x]",
        "path": "Consent.source[x]",
        "comment": "The source can be contained inline (Attachment), referenced directly (Consent), referenced in a consent repository (DocumentReference), or simply by an identifier (Identifier), e.g. a CDA document id.\r\n\r\nCyprusEHR: Not to be used in the context of Cyprus EHR for now. Later, for the prototype of the national integrated EHR of Cyprus, only the reference to consent instances will be used (and more specifically cyehr-sd-consentpreference type)."
      },
      {
        "id": "Consent.policy",
        "path": "Consent.policy",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Consent.policy.authority",
        "path": "Consent.policy.authority",
        "comment": "see http://en.wikipedia.org/wiki/Uniform_resource_identifier\r\n\r\nCyprusEHR: The National eHealth Autority.",
        "fixedUri": "http://www.neha.gov.cy/moh/neha/neha.nsf/home_en/home_en?openform"
      },
      {
        "id": "Consent.policy.uri",
        "path": "Consent.policy.uri",
        "comment": "This element is for discoverability / documentation and does not modify or qualify the policy rules.\r\n\r\nCyprusEHR: The policy of granting a healthcare provider access to a patient's EHR health data. Temporarily the current eHealth law is given as fixed value but in the future it must be replaced by a more specific policy defining explicitely what is the content of the consent for a paitnet granting a healthcare provider with access to his/her EHR health data.",
        "fixedUri": "http://www.cylaw.org/nomoi/enop/non-ind/2019_1_59/index.html"
      },
      {
        "id": "Consent.policyRule",
        "path": "Consent.policyRule",
        "type": [
          {
            "code": "CodeableConcept",
            "profile": [
              "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips"
            ]
          }
        ],
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "GRANTORCHOICE"
            }
          ]
        }
      },
      {
        "id": "Consent.policyRule.coding",
        "path": "Consent.policyRule.coding",
        "min": 1
      },
      {
        "id": "Consent.verification",
        "path": "Consent.verification",
        "comment": "CyprusEHR: Not to be used for eHealth4U."
      },
      {
        "id": "Consent.provision",
        "path": "Consent.provision",
        "definition": "An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.\r\n\r\nCyprusEHR: For the prototype of the national integrated EHR, a healthcare provider shall be granted with a consent by the patient in order to be able to access the patient's EHR health data. Absence of an active consent between the patient and the healthcare provider means the latter is not allowed to access any data of this patient. Therefore, an instance of this profile shall be created if and only if the patient proposed a consent and the healthcare provider accepted to provide services based on the proposed consent and therefore, the healthcare provider gains access to the patient's EHR health data as directed by the agreed consent. In this framework, the root provision.type will be always \"permit\" declaring the agreement of the patient to the policy. The nested provision can be then used to define any further restrictions in terms of data and actions that were included in the consent proposal created by the patient in the beginning of the consent ceremony process.",
        "min": 1
      },
      {
        "id": "Consent.provision.type",
        "path": "Consent.provision.type",
        "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size\r\n\r\nCyprusEHR: It shall be \"permit\" in the root provision meaining that the Patient agrees with the consent's policy. Then first level provision (provision.provision.type) can be deny if the Patient denies access to data to the selected healthcare provider. Second level provision (provision.provision.provision) and thereafter can be defined with \"deny\" type to specify which data are denied to specific members of the medical team.",
        "min": 1,
        "fixedCode": "permit"
      },
      {
        "id": "Consent.provision.period",
        "path": "Consent.provision.period",
        "comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).\r\n\r\nCyprusEHR: Shall be defined only for the root \"permit\" provision and updated automatically based on consent lifetime rules defined in the policy. If root provision.period expires AND the status of the instance is active, the instance shall become inactivated."
      },
      {
        "id": "Consent.provision.period.start",
        "path": "Consent.provision.period.start",
        "min": 1
      },
      {
        "id": "Consent.provision.period.end",
        "path": "Consent.provision.period.end",
        "min": 1
      },
      {
        "id": "Consent.provision.actor",
        "path": "Consent.provision.actor",
        "mustSupport": true
      },
      {
        "id": "Consent.provision.actor.role",
        "path": "Consent.provision.actor.role",
        "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.\r\n\r\nCyprusEHR: Use the code http://terminology.hl7.org/CodeSystem/v3-ParticipationType|PRCP and reference the medical team in root provision  (representing the restrictions imposed by the patient in the consent preference). Use the code http://terminology.hl7.org/CodeSystem/v3-ParticipationType|PRCP and reference particular healthcare associate practitioner roles to further restrict access to data to members of the medical team (imposed by the head practitioner role of the medical team).",
        "type": [
          {
            "code": "CodeableConcept",
            "profile": [
              "http://hl7.org/fhir/uv/ips/StructureDefinition/CodeableConcept-uv-ips"
            ]
          }
        ],
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
              "code": "PRCP"
            }
          ]
        }
      },
      {
        "id": "Consent.provision.actor.role.coding",
        "path": "Consent.provision.actor.role.coding",
        "min": 1
      },
      {
        "id": "Consent.provision.actor.role.coding.system",
        "path": "Consent.provision.actor.role.coding.system",
        "min": 1
      },
      {
        "id": "Consent.provision.actor.role.coding.code",
        "path": "Consent.provision.actor.role.coding.code",
        "min": 1
      },
      {
        "id": "Consent.provision.actor.role.coding.display",
        "path": "Consent.provision.actor.role.coding.display",
        "min": 1
      },
      {
        "id": "Consent.provision.actor.reference",
        "path": "Consent.provision.actor.reference",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-practitionerrolehealthcareassociate-r4",
              "http://ig.ehealth4u.eu/fhir/StructureDefinition/cyehr-sd-medicalteam-r4"
            ]
          }
        ]
      },
      {
        "id": "Consent.provision.actor.reference.reference",
        "path": "Consent.provision.actor.reference.reference",
        "min": 1
      },
      {
        "id": "Consent.provision.action",
        "path": "Consent.provision.action",
        "comment": "Note that this is the direct action (not the grounds for the action covered in the purpose element). At present, the only action in the understood and tested scope of this resource is 'read'.\r\n\r\nCyprusEHR: When all actions must be denied or permitted this is left empty. For eHealth4U first phase shall be left empty.",
        "mustSupport": false
      },
      {
        "id": "Consent.provision.action.coding.system",
        "path": "Consent.provision.action.coding.system",
        "min": 1
      },
      {
        "id": "Consent.provision.action.coding.code",
        "path": "Consent.provision.action.coding.code",
        "min": 1
      },
      {
        "id": "Consent.provision.action.coding.display",
        "path": "Consent.provision.action.coding.display",
        "min": 1
      },
      {
        "id": "Consent.provision.securityLabel",
        "path": "Consent.provision.securityLabel",
        "comment": "If the consent specifies a security label of \"R\" then it applies to all resources that are labeled \"R\" or lower. E.g. for Confidentiality, it's a high water mark. For other kinds of security labels, subsumption logic applies. When the purpose of use tag is on the data, access request purpose of use shall not conflict.\r\n\r\nCyprusEHR: Not to be used in the first phase of eHealth4U."
      },
      {
        "id": "Consent.provision.purpose",
        "path": "Consent.provision.purpose",
        "comment": "When the purpose of use tag is on the data, access request purpose of use shall not conflict.\r\n\r\nCyprusEHR: Not to be used in the context of Cyprus EHR."
      },
      {
        "id": "Consent.provision.class",
        "path": "Consent.provision.class",
        "comment": "Multiple types are or'ed together. The intention of the contentType element is that the codes refer to profiles or document types defined in a standard or an implementation guide somewhere.\r\n\r\nCyprusEHR: Use to allow patient to deny access to a specific category of data to be locked (e.g. all allergies, all medication)."
      },
      {
        "id": "Consent.provision.code",
        "path": "Consent.provision.code",
        "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.\r\n\r\nCyprusEHR: Not to be used in the context of Cyprus EHR.",
        "mustSupport": false
      },
      {
        "id": "Consent.provision.dataPeriod",
        "path": "Consent.provision.dataPeriod",
        "comment": "This has a different sense to the Consent.period - that is when the consent agreement holds. This is the time period of the data that is controlled by the agreement.\r\n\r\nCyprusEHR: Not to be used in the context of Cyprus EHR."
      },
      {
        "id": "Consent.provision.data",
        "path": "Consent.provision.data",
        "comment": "CyprusEHR: Use for \"deny\" nested provsions to specify the exact data for whcih access is denied."
      },
      {
        "id": "Consent.provision.data.meaning",
        "path": "Consent.provision.data.meaning",
        "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size\r\n\r\nCyprusEHR: The code \"instance\" shall be used. An explanatory note should be presetend to the patient declaring that any other data related to the selected data will be presented unless also selected to be locked."
      },
      {
        "id": "Consent.provision.data.reference.reference",
        "path": "Consent.provision.data.reference.reference",
        "min": 1
      },
      {
        "id": "Consent.provision.provision",
        "path": "Consent.provision.provision",
        "comment": "CyprusEHR: Use it with a \"deny\" type to define the patient's locked data if the patient wishes to lock/hide data.",
        "contentReference": "http://hl7.org/fhir/StructureDefinition/Consent#Consent.provision"
      }
    ]
  }
}