RIVO-Noord Zorgviewer Implementation Guide
1.1.0 - sprint35 Netherlands flag

RIVO-Noord Zorgviewer Implementation Guide - Local Development build (v1.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Practitioner - Detailed Descriptions

Draft as of 2024-06-21

Definitions for the Practitioner resource profile.

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

0. Practitioner
Invariantszv-pra-3: Either Practitioner BIG or AGB-Z identifier SHALL be present. (identifier.where(system='http://fhir.nl/fhir/NamingSystem/agb-z') or identifier.where(system='http://fhir.nl/fhir/NamingSystem/big'))
2. Practitioner.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
4. Practitioner.identifier:AGB
Slice NameAGB
NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
6. Practitioner.identifier:BIG
Slice NameBIG
NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
8. Practitioner.name
Control1..?
Must Supporttrue
Invariantszv-pra-1: Either Practitioner.name.given and/or Practitioner.name.family and/or Practitioner.name.text SHALL be present. ((family.exists() or given.exists() or text.exists()))
zv-pra-2: To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. (text.exists())
10. Practitioner.qualification
BindingUnless not suitable, these codes SHALL be taken from Subject rol (beroepen) waardelijst
(extensible to http://hl7.nl/fhir/zorgviewer/ValueSet/SubjectRoleCodelist)

Subject rol waardelijst. Deze rol is nodig voor autorisatie bij de bron.

Invariantszv-pra-4: A SNOMED CT (beroep) code SHOULD be present. (code.coding.where(system='http://snomed.info/sct'))

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.

ShortHealthProfessionalA person with a formal responsibility in the provisioning of healthcare or related services
Comments

Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?

Control0..*
Alternate NamesZorgverlener
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
zv-pra-3: Either Practitioner BIG or AGB-Z identifier SHALL be present. (identifier.where(system='http://fhir.nl/fhir/NamingSystem/agb-z') or identifier.where(system='http://fhir.nl/fhir/NamingSystem/big'))
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
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.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
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. Usually modifier elements provide negation or qualification. In order 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.

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 No Modifier Reason provideed in previous versions of FHIR
Alternate Namesextensions, user content
6. Practitioner.identifier
Definition

The health professional identification number is a number that uniquely identifies the health professional.

The following numbers are used in the Netherlands: 1. UZI Health Professionals. Identification of health professionals (people) in the Dutch healthcare industry. 2. VEKTIS AGB-Z. Identifies health professionals and healthcare organizations. 3. BIG-ID. The ID of the health professional listed in the BIG Register.

This information is not readily available for foreign health professionals.


An identifier that applies to this person in this role.

ShortHealthProfessionalIdentificationNumberA identifier for the person as this agent
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Summarytrue
Requirements

Often, specific identities are assigned for the agent.

Alternate NamesZorgverlenerIdentificatieNummer
SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ system
  • 8. Practitioner.identifier:UZI
    Slice NameUZI
    Definition

    Unieke Zorgverlener Identificatie (Dutch physician identification number)


    An identifier that applies to this person in this role.

    ShortUZIA identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Alternate NamesUZI
    10. Practitioner.identifier:UZI.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary (If known)
    Comments

    This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use
    (required to http://hl7.org/fhir/ValueSet/identifier-use)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

    12. Practitioner.identifier:UZI.system
    Definition

    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

    ShortThe namespace for the identifier value
    Control10..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    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.

    Fixed Valuehttp://fhir.nl/fhir/NamingSystem/uzi-nr-pers
    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
    14. Practitioner.identifier:UZI.value
    Definition

    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

    ShortThe value that is unique
    Comments

    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.

    Control10..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Example<br/><b>General</b>:123456 <br/><b>Example</b>:01011234
    16. Practitioner.identifier:AGB
    Slice NameAGB
    Definition

    An identifier that applies to this person in this role.

    ShortAGBA identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier
    Must Supporttrue
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Alternate NamesAGB
    18. Practitioner.identifier:AGB.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary (If known)
    Comments

    This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use
    (required to http://hl7.org/fhir/ValueSet/identifier-use)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

    20. Practitioner.identifier:AGB.system
    Definition

    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

    ShortThe namespace for the identifier value
    Control10..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    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.

    Fixed Valuehttp://fhir.nl/fhir/NamingSystem/agb-z
    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
    22. Practitioner.identifier:AGB.value
    Definition

    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

    ShortThe value that is unique
    Comments

    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.

    Control10..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Example<br/><b>General</b>:123456 <br/><b>Example</b>:123456
    24. Practitioner.identifier:BIG
    Slice NameBIG
    Definition

    An identifier that applies to this person in this role.

    ShortBIGA identifier for the person as this agent
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1*
    TypeIdentifier
    Must Supporttrue
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Alternate NamesBIG
    26. Practitioner.identifier:BIG.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary (If known)
    Comments

    This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use
    (required to http://hl7.org/fhir/ValueSet/identifier-use)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

    28. Practitioner.identifier:BIG.system
    Definition

    Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

    ShortThe namespace for the identifier value
    Control10..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    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.

    Fixed Valuehttp://fhir.nl/fhir/NamingSystem/big
    Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
    30. Practitioner.identifier:BIG.value
    Definition

    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

    ShortThe value that is unique
    Comments

    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.

    Control10..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Example<br/><b>General</b>:123456 <br/><b>Example</b>:12345678
    32. Practitioner.name
    Definition

    Health professional’s full name. If a health professional identification number is entered, it will be the name as listed in UZI, AGB or by the healthcare center.


    The name(s) associated with the practitioner.

    ShortNameInformationThe name(s) associated with the practitioner
    Comments

    Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information.

    The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around.

    Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification.

    The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the .use element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for receiving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of .given names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials.

    Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while receiving systems should be able to handle this one-instance approach. More specifically:

    • Sending and receiving systems SHOULD always use the specified extensions when using this datatype.
    • Sending systems are encouraged to populate the .text element to unambigiously communicate the person's name.
    • Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in .given.
    • When a sending system uses the current one-instance approach for communicating multiple representations, .use MAY NOT be populated. After all, it is not possible to select a single .use when the instance contains different representations.
    • When a receiving system interprets the instance as the single-instance-multiple-representations approach, the .given names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when:
    • They encounter a single instance
    • And the .use element is absent
    • And all the name parts are differentiated using the specified extensions
    • In any other circumstance, receiving systems SHOULD interpret the usage as the normal use.

    Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas:

    • .family = "Jongeneel-de Haas"
    • .given = "Irma" (with .given:iso21090EnQualifier = BR)
    • .family:humannameOwnName = "Jongeneel"
    • .family:humannamePartnerPrefix = "de "
    • .family:humannamePartnerName = "Haas"

    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..*
    This element is affected by the following invariants: ele-1
    TypeHumanName(nl-core-humanname)
    Must Supporttrue
    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.

    Alternate NamesNaamgegevens
    Example<br/><b>Structured HumanName (preferred above unstructured)</b>:{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode" : "NL4" }], "text" : "Irma Jongeneel-de Haas", "family" : "Jongeneel-de Haas", "_family" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString" : "Jongeneel" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString" : "de" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString" : "Haas" }] }, "given" : ["Irma"], "_given" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode" : "CL" }] }] } <br/><b>Unstructured HumanName</b>:{ "text" : "Irma Jongeneel-de Haas" }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    nl-core-humanname-1: if you specify a prefix for an own name then an own name is also expected (name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not())
    nl-core-humanname-2: if you specify a voorvoegsel for a partner name then a partner name is also expected (name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not())
    zv-pra-1: Either Practitioner.name.given and/or Practitioner.name.family and/or Practitioner.name.text SHALL be present. ((family.exists() or given.exists() or text.exists()))
    zv-pra-2: To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. (text.exists())
    34. Practitioner.address
    Definition

    This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.

    To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.

    Separate address parts

    The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.

    Custom address types

    The second addition is that the HCIM defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the HCIM concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The HCIM code itself should also be included using the AddressType extension.

    | HCIM |.ext:AddressType | .ext:official | .use | .type | |-----------------------------------|:------------------:|:---------------:|:------:|:----------:| | Postal Address/Postadres | PST | | | postal | | Primary Home/Officieel adres | HP | true | home | | | Visit Address/Woon-/verblijfadres | PHYS | | home | physical | | Temporary Address/Tijdelijk adres | TMP | | temp | | | Work Place/Werkadres | WP | | work | | | Vacation Home/Vakantie adres | HV | | temp | |

    If Address.type is both then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.

    NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.


    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.

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

    Note: address is for postal addresses, not physical locations.


    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..*
    This element is affected by the following invariants: ele-1, nl-streetname-if-official-and-other-line-parts
    TypeAddress(nl-core-address)
    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.

    Alternate NamesAdresInformatie, Adresgegevens
    Example<br/><b>Example of a Vacation Home address</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HV", "display" : "Vakantie adres" }] } }], "use" : "temp", "line" : ["Binnenkant 12A Hoog"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "12" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString" : "A" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString" : "Hoog" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1000AA", "country" : "NLD" } <br/><b>Example of a Primary Home address</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HP", "display" : "Officieel adres" }] } }, { "url" : "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean" : true }], "use" : "home", "line" : ["Binnenkant to 10"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString" : "to" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "10" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1001AA", "country" : "NLD" }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    nl-streetname-if-official-and-other-line-parts: Address.streetName in an official address SHALL have a value if one of houseNumber|buildingNumberSuffix|additionalLocator has a value ((extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not())))
    36. Practitioner.qualification
    Definition

    Qualifications obtained by training and certification.

    ShortQualifications obtained by training and certification
    Control0..*
    TypeBackboneElement
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    zv-pra-4: A SNOMED CT (beroep) code SHOULD be present. (code.coding.where(system='http://snomed.info/sct'))
    ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    38. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

    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 No Modifier Reason provideed in previous versions of FHIR
    Summarytrue
    Alternate Namesextensions, user content, modifiers
    40. Practitioner.qualification.code
    Definition

    Coded representation of the qualification.

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

    Specific qualification the practitioner has to provide a service

    TypeCodeableConcept

    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.

    ShortHealthProfessional
    Comments

    Note that a cab driver no longer fits the bill. You probably would be interested in the organization rather than the individual?

    Control0..*
    Alternate NamesZorgverlener
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
    zv-pra-3: Either Practitioner BIG or AGB-Z identifier SHALL be present. (identifier.where(system='http://fhir.nl/fhir/NamingSystem/agb-z') or identifier.where(system='http://fhir.nl/fhir/NamingSystem/big'))
    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
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    4. Practitioner.meta
    Definition

    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

    ShortMetadata about the resource
    Control0..1
    TypeMeta
    Summarytrue
    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.

    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.

    This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

    Control0..1
    Typeuri
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    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
    BindingUnless not suitable, these codes SHALL be taken from Common Languages
    (extensible to http://hl7.org/fhir/ValueSet/languages)

    A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    10. Practitioner.text
    Definition

    A human-readable narrative that contains a summary of the resource, and may 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 in formation is added later.

    Control0..1
    This element is affected by the following invariants: dom-1
    TypeNarrative
    Alternate Namesnarrative, html, xhtml, display
    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.

    Control0..*
    TypeResource
    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. In order 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.

    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
    Alternate Namesextensions, user content
    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. Usually modifier elements provide negation or qualification. In order 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.

    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 No Modifier Reason provideed in previous versions of FHIR
    Alternate Namesextensions, user content
    18. Practitioner.identifier
    Definition

    The health professional identification number is a number that uniquely identifies the health professional.

    The following numbers are used in the Netherlands: 1. UZI Health Professionals. Identification of health professionals (people) in the Dutch healthcare industry. 2. VEKTIS AGB-Z. Identifies health professionals and healthcare organizations. 3. BIG-ID. The ID of the health professional listed in the BIG Register.

    This information is not readily available for foreign health professionals.

    ShortHealthProfessionalIdentificationNumber
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..*
    TypeIdentifier
    Summarytrue
    Requirements

    Often, specific identities are assigned for the agent.

    Alternate NamesZorgverlenerIdentificatieNummer
    SlicingThis element introduces a set of slices on Practitioner.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 20. Practitioner.identifier:UZI
      Slice NameUZI
      Definition

      Unieke Zorgverlener Identificatie (Dutch physician identification number)

      ShortUZI
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1
      TypeIdentifier
      Summarytrue
      Requirements

      Often, specific identities are assigned for the agent.

      Alternate NamesUZI
      22. Practitioner.identifier:UZI.id
      Definition

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

      Shortxml:id (or equivalent in JSON)
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      24. Practitioner.identifier:UZI.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. In order 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.

      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
      Alternate Namesextensions, user content
      SlicingThis element introduces a set of slices on Practitioner.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 26. Practitioner.identifier:UZI.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary (If known)
        Comments

        This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUse
        (required to http://hl7.org/fhir/ValueSet/identifier-use)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

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

        28. Practitioner.identifier:UZI.type
        Definition

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        ShortDescription of identifier
        Comments

        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.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TypeCodeableConcept
        Summarytrue
        Requirements

        Allows users to make use of identifiers when the identifier system is not known.

        30. Practitioner.identifier:UZI.system
        Definition

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Control1..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        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.

        Fixed Valuehttp://fhir.nl/fhir/NamingSystem/uzi-nr-pers
        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        32. Practitioner.identifier:UZI.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        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.

        Control1..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Example<br/><b>General</b>:123456 <br/><b>Example</b>:01011234
        34. Practitioner.identifier:UZI.period
        Definition

        Time period during which identifier is/was valid for use.

        ShortTime period when id is/was valid for use
        Control0..1
        TypePeriod
        Summarytrue
        36. Practitioner.identifier:UZI.assigner
        Definition

        Organization that issued/manages the identifier.

        ShortOrganization that issued id (may be just text)
        Comments

        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.

        Control0..1
        TypeReference(Organization)
        Summarytrue
        38. Practitioner.identifier:AGB
        Slice NameAGB
        Definition

        An identifier that applies to this person in this role.

        ShortAGB
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        TypeIdentifier
        Must Supporttrue
        Summarytrue
        Requirements

        Often, specific identities are assigned for the agent.

        Alternate NamesAGB
        40. Practitioner.identifier:AGB.id
        Definition

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

        Shortxml:id (or equivalent in JSON)
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        42. Practitioner.identifier:AGB.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. In order 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.

        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
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on Practitioner.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 44. Practitioner.identifier:AGB.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary (If known)
          Comments

          This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUse
          (required to http://hl7.org/fhir/ValueSet/identifier-use)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

          46. Practitioner.identifier:AGB.type
          Definition

          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

          ShortDescription of identifier
          Comments

          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.

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
          (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

          A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

          TypeCodeableConcept
          Summarytrue
          Requirements

          Allows users to make use of identifiers when the identifier system is not known.

          48. Practitioner.identifier:AGB.system
          Definition

          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

          ShortThe namespace for the identifier value
          Control1..1
          Typeuri
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          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.

          Fixed Valuehttp://fhir.nl/fhir/NamingSystem/agb-z
          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
          50. Practitioner.identifier:AGB.value
          Definition

          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

          ShortThe value that is unique
          Comments

          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.

          Control1..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Example<br/><b>General</b>:123456 <br/><b>Example</b>:123456
          52. Practitioner.identifier:AGB.period
          Definition

          Time period during which identifier is/was valid for use.

          ShortTime period when id is/was valid for use
          Control0..1
          TypePeriod
          Summarytrue
          54. Practitioner.identifier:AGB.assigner
          Definition

          Organization that issued/manages the identifier.

          ShortOrganization that issued id (may be just text)
          Comments

          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.

          Control0..1
          TypeReference(Organization)
          Summarytrue
          56. Practitioner.identifier:BIG
          Slice NameBIG
          Definition

          An identifier that applies to this person in this role.

          ShortBIG
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1
          TypeIdentifier
          Must Supporttrue
          Summarytrue
          Requirements

          Often, specific identities are assigned for the agent.

          Alternate NamesBIG
          58. Practitioner.identifier:BIG.id
          Definition

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

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          60. Practitioner.identifier:BIG.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

          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
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on Practitioner.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 62. Practitioner.identifier:BIG.use
            Definition

            The purpose of this identifier.

            Shortusual | official | temp | secondary (If known)
            Comments

            This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

            Control0..1
            BindingThe codes SHALL be taken from IdentifierUse
            (required to http://hl7.org/fhir/ValueSet/identifier-use)

            Identifies the purpose for this identifier, if known .

            Typecode
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

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

            64. Practitioner.identifier:BIG.type
            Definition

            A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

            ShortDescription of identifier
            Comments

            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.

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
            (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

            A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

            TypeCodeableConcept
            Summarytrue
            Requirements

            Allows users to make use of identifiers when the identifier system is not known.

            66. Practitioner.identifier:BIG.system
            Definition

            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

            ShortThe namespace for the identifier value
            Control1..1
            Typeuri
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            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.

            Fixed Valuehttp://fhir.nl/fhir/NamingSystem/big
            Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
            68. Practitioner.identifier:BIG.value
            Definition

            The portion of the identifier typically relevant to the user and which is unique within the context of the system.

            ShortThe value that is unique
            Comments

            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.

            Control1..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Example<br/><b>General</b>:123456 <br/><b>Example</b>:12345678
            70. Practitioner.identifier:BIG.period
            Definition

            Time period during which identifier is/was valid for use.

            ShortTime period when id is/was valid for use
            Control0..1
            TypePeriod
            Summarytrue
            72. Practitioner.identifier:BIG.assigner
            Definition

            Organization that issued/manages the identifier.

            ShortOrganization that issued id (may be just text)
            Comments

            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.

            Control0..1
            TypeReference(Organization)
            Summarytrue
            74. Practitioner.active
            Definition

            Whether this practitioner's record is in active use.

            ShortWhether this practitioner's record is in active use
            Comments

            Default is true.

            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
            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.

            Default Valuetrue
            76. Practitioner.name
            Definition

            Health professional’s full name. If a health professional identification number is entered, it will be the name as listed in UZI, AGB or by the healthcare center.

            ShortNameInformation
            Comments

            Dutch names require that certain name parts are separately communicable. For this reason, extensions are added onto the base HumanName element to mark the meaning of each part. A Dutch HumanName is still a proper FHIR HumanName; however, there might be an incompatibilty with the default FHIR mechanism for communicating given names. See the compatibility note below for more information.

            The extension elements cover birth name (NL: eigennaam / geslachtsnaam) and partner/spouse name. Both may have a prefix (NL: voorvoegsel). When a person marries, he or she may keep their own name, assume the partner name, append the partner name to their own name, or the other way around.

            Incompatibility note: It has come to light that this specification deviates from the way that the HumanName datatype is normally used. This will be fixed in a future release. However, current implementations should be aware of the special considerations regarding the use of this specification.

            The issue at hand is the way alternative representations of a name, like initials or a nickname, are communicated. Normally this is done using multiple HumanName instances, which are differentiated using the .use element. However, this specification allows for including all alternative representations in the same HumanName instance, with the expectation that the extensions provide enough information for receiving systems to differentiate them. However, this means that contrary to the normal usage of this datatype, repetitions of .given names cannot be concatenated to get the full list of given names; the list might be a mix of full names, nicknames and initials.

            Since multiple implementations are based on this specification, sending systems are advised (but not required) to keep the approach with one HumanName instance, while receiving systems should be able to handle this one-instance approach. More specifically:

            • Sending and receiving systems SHOULD always use the specified extensions when using this datatype.
            • Sending systems are encouraged to populate the .text element to unambigiously communicate the person's name.
            • Sending systems are encouraged to send either the full given names or the initials, but not both. This alleviates the duplication of names in .given.
            • When a sending system uses the current one-instance approach for communicating multiple representations, .use MAY NOT be populated. After all, it is not possible to select a single .use when the instance contains different representations.
            • When a receiving system interprets the instance as the single-instance-multiple-representations approach, the .given names marked as initials SHOULD be interpreted as alternatives to the full given names. Note the underlying HCIM expects both the list of full names and list of initials to be a single string; there's no match for an initial to a full name. The instance SHOULD be regarded as using this approach when:
            • They encounter a single instance
            • And the .use element is absent
            • And all the name parts are differentiated using the specified extensions
            • In any other circumstance, receiving systems SHOULD interpret the usage as the normal use.

            Example: miss Irma Jongeneel marries mister de Haas and assumes the name Irma Jongeneel-de Haas:

            • .family = "Jongeneel-de Haas"
            • .given = "Irma" (with .given:iso21090EnQualifier = BR)
            • .family:humannameOwnName = "Jongeneel"
            • .family:humannamePartnerPrefix = "de "
            • .family:humannamePartnerName = "Haas"
            Control1..*
            This element is affected by the following invariants: ele-1
            TypeHumanName(nl-core-humanname)
            Must Supporttrue
            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.

            Alternate NamesNaamgegevens
            Example<br/><b>Structured HumanName (preferred above unstructured)</b>:{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-assembly-order", "valueCode" : "NL4" }], "text" : "Irma Jongeneel-de Haas", "family" : "Jongeneel-de Haas", "_family" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/humanname-own-name", "valueString" : "Jongeneel" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix", "valueString" : "de" }, { "url" : "http://hl7.org/fhir/StructureDefinition/humanname-partner-name", "valueString" : "Haas" }] }, "given" : ["Irma"], "_given" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier", "valueCode" : "CL" }] }] } <br/><b>Unstructured HumanName</b>:{ "text" : "Irma Jongeneel-de Haas" }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            nl-core-humanname-1: if you specify a prefix for an own name then an own name is also expected (name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-own-name').empty().not())
            nl-core-humanname-2: if you specify a voorvoegsel for a partner name then a partner name is also expected (name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-prefix').empty().not() implies name.family.extension('http://hl7.org/fhir/StructureDefinition/humanname-partner-name').empty().not())
            zv-pra-1: Either Practitioner.name.given and/or Practitioner.name.family and/or Practitioner.name.text SHALL be present. ((family.exists() or given.exists() or text.exists()))
            zv-pra-2: To be usable for a wide range of internationally available applications, the Patient.name.text SHOULD be present. (text.exists())
            78. Practitioner.telecom
            Definition

            Contact information includes a person's telephone numbers and email addresses. This datatype defines a common basis for expressing all contact information around the world, but adds extensions to express Dutch contacts specifically, according to the HCIM ContactInformation (v1.0, 2017). A Dutch ContactPoint still is a proper FHIR ContactPoint, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype. The table below explains how the HCIM concepts are mapped to the various FHIR elements. The HCIM code itself should also be included using the TelecomType extension.

            | HCIM | .ext:TelecomType | .system | .use | |----------------------------------------------------|:------------------:|:---------:|:--------:| | Primary Home Land Line | LL | phone | home | | Temporary Land Line | LL | phone | temp | | Primary Work Land Line | LL | phone | work | | | | | | | Primary Home Fax | FAX | fax | home | | Temporary Fax | FAX | fax | temp | | Primary Work Fax | FAX | fax | work | | | | | | | Primary Home Mobile Phone | MC | phone | home | | Temporary Mobile Phone | MC | phone | temp | | Primary Work Mobile Phone | MC | phone | work | | | | | | | Primary Home Pager | PG | pager | home | | Temporary Pager | PG | pager | temp | | Primary Work Pager | PG | pager | work | | | | | | | Private email address | | email | home | | Work email address | | email | work | | | | | | | Mobile phone number undetermined private/business | | phone | mobile |

            ShortContactInformation
            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 also to help with identification

            These typically will have home numbers, or mobile numbers that are not role specific.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeContactPoint(nl-core-contactpoint)
            Requirements

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

            Alternate NamesContactgegevens
            Example<br/><b>Mobile business phone number. Note: the mobile nature stems from the number being an 06-* number.</b>:{ "system" : "phone", "value" : "+31611234567", "use" : "work" } <br/><b>Mobile phone number undetermined private/business. Note: the mobile nature stems from the number being an 06-* number.</b>:{ "system" : "phone", "value" : "+31611234567", "use" : "mobile" } <br/><b>Primary Home Land Line</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "home" } <br/><b>Temporary Land Line</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "temp" } <br/><b>Primary Work Land Line</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "LL", "display" : "Land Line" }] } }], "system" : "phone", "value" : "...", "use" : "work" } <br/><b>Primary Home Fax</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "home" } <br/><b>Temporary Fax</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "temp" } <br/><b>Primary Work Fax</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.22.1", "code" : "FAX", "display" : "Fax" }] } }], "system" : "fax", "value" : "...", "use" : "work" } <br/><b>Primary Home Mobile Phone</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "home" } <br/><b>Temporary Mobile Phone</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "temp" } <br/><b>Primary Work Mobile Phone</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "MC", "display" : "Mobile Phone" }] } }], "system" : "phone", "value" : "...", "use" : "work" } <br/><b>Primary Home Pager</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "home" } <br/><b>Temporary Pager</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "temp" } <br/><b>Primary Work Pager</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelecomType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "PG", "display" : "Pager" }] } }], "system" : "pager", "value" : "...", "use" : "work" } <br/><b>Private email address</b>:{ "system" : "email", "value" : "giesput@myweb.nl", "use" : "home" } <br/><b>Work email address</b>:{ "system" : "email", "value" : "example@workplace.nl", "use" : "work" }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            cpt-2: A system is required if a value is provided. (value.empty() or system.exists())
            80. Practitioner.address
            Definition

            This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the HCIM AddressInformation (v1.0, 2017). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.

            To have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.

            Separate address parts

            The first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.

            Custom address types

            The second addition is that the HCIM defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the HCIM concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The HCIM code itself should also be included using the AddressType extension.

            | HCIM |.ext:AddressType | .ext:official | .use | .type | |-----------------------------------|:------------------:|:---------------:|:------:|:----------:| | Postal Address/Postadres | PST | | | postal | | Primary Home/Officieel adres | HP | true | home | | | Visit Address/Woon-/verblijfadres | PHYS | | home | physical | | Temporary Address/Tijdelijk adres | TMP | | temp | | | Work Place/Werkadres | WP | | work | | | Vacation Home/Vakantie adres | HV | | temp | |

            If Address.type is both then this is to be understood as a dual purpose address (postal and physical). Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.

            NOTE: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the HCIM ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.

            ShortAddressInformation
            Comments

            Note: address is for postal addresses, not physical locations.

            Control0..*
            This element is affected by the following invariants: ele-1, nl-streetname-if-official-and-other-line-parts
            TypeAddress(nl-core-address)
            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.

            Alternate NamesAdresInformatie, Adresgegevens
            Example<br/><b>Example of a Vacation Home address</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HV", "display" : "Vakantie adres" }] } }], "use" : "temp", "line" : ["Binnenkant 12A Hoog"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "12" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix", "valueString" : "A" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-unitID", "valueString" : "Hoog" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1000AA", "country" : "NLD" } <br/><b>Example of a Primary Home address</b>:{ "extension" : [{ "url" : "http://nictiz.nl/fhir/StructureDefinition/zib-AddressInformation-AddressType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/v3/AddressUse", "code" : "HP", "display" : "Officieel adres" }] } }, { "url" : "http://fhir.nl/fhir/StructureDefinition/nl-core-address-official", "valueBoolean" : true }], "use" : "home", "line" : ["Binnenkant to 10"], "_line" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName", "valueString" : "Binnenkant" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator", "valueString" : "to" }, { "url" : "http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber", "valueString" : "10" }] }], "city" : "Amsterdam", "state" : "NH", "postalCode" : "1001AA", "country" : "NLD" }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            nl-streetname-if-official-and-other-line-parts: Address.streetName in an official address SHALL have a value if one of houseNumber|buildingNumberSuffix|additionalLocator has a value ((extension.where(url = 'http://fhir.nl/fhir/StructureDefinition/nl-core-address-official').where(value = true)).empty() or (line.extension.where(url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-streetName').empty().not() and (line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-houseNumber').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-buildingNumberSuffix').empty().not() or line.extension.where(url='http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-additionalLocator').empty().not())))
            82. 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)

            The gender of a person used for administrative purposes.

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

            Needed to address the person correctly.

            84. Practitioner.birthDate
            Definition

            The date of birth for the practitioner.

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

            Needed for identification.

            86. Practitioner.photo
            Definition

            Image of the person.

            ShortImage of the person
            Control0..*
            TypeAttachment
            Requirements

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

            88. Practitioner.qualification
            Definition

            Qualifications obtained by training and certification.

            ShortQualifications obtained by training and certification
            Control0..*
            TypeBackboneElement
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            zv-pra-4: A SNOMED CT (beroep) code SHOULD be present. (code.coding.where(system='http://snomed.info/sct'))
            90. 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.

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            92. Practitioner.qualification.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. In order 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.

            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
            Alternate Namesextensions, user content
            94. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

            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 No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            96. 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
            Requirements

            Often, specific identities are assigned for the qualification.

            98. 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://hl7.org/fhir/ValueSet/v2-2.7-0360)

            Specific qualification the practitioner has to provide a service

            TypeCodeableConcept
            100. Practitioner.qualification.period
            Definition

            Period during which the qualification is valid.

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

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

            102. Practitioner.qualification.issuer
            Definition

            Organization that regulates and issues the qualification.

            ShortOrganization that regulates and issues the qualification
            Control0..1
            TypeReference(Organization)
            104. Practitioner.communication
            Definition

            A language the practitioner is able to use in patient communication.

            ShortA language the practitioner is able to 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 actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

            Control0..*
            BindingUnless not suitable, these codes SHALL be taken from Common Languages
            (extensible to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            TypeCodeableConcept
            Requirements

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