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: ToestemmingConsent - Detailed Descriptions

Draft as of 2024-06-21

Definitions for the ToestemmingConsent resource profile.

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

0. Consent
2. Consent.status
Must Supporttrue
4. Consent.category
6. Consent.category.coding
8. Consent.category.coding.code
Must Supporttrue
Fixed ValueDoss. delen?
10. Consent.patient
TypeReference(Patient)
Must Supporttrue
12. Consent.period
Must Supporttrue
14. Consent.organization
TypeReference(Organization)
Must Supporttrue
16. Consent.policy
Must Supporttrue
18. Consent.policy.uri
Must Supporttrue
Fixed Valuehttps://rivo-noord.nl/zorgviewer/toestemming

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

0. Consent
Definition

A record of a healthcare consumer’s policy choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.

ShortA healthcare consumer's policy choices to permits or denies recipients or roles to perform actions for specific purposes and periods of time
Comments

Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.

Control0..*
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())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
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())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
2. Consent.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. Consent.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. Consent.status
Definition

Indicates the current state of this consent.

Shortdraft | proposed | active | rejected | inactive | entered-in-error
Comments

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.

Control1..1
BindingThe codes SHALL be taken from ConsentStatehttp://hl7.org/fhir/ValueSet/consent-state-codes
(required to http://hl7.org/fhir/ValueSet/consent-state-codes)

Indicates the state of the consent

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
Must Supporttrue
Summarytrue
Requirements

The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.

8. Consent.category
Definition

A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.

ShortClassification of the consent statement - for indexing/retrieval
Control0..*
BindingFor example codes, see Consent Category Codeshttp://hl7.org/fhir/ValueSet/consent-category
(example to http://hl7.org/fhir/ValueSet/consent-category)

A classification of the type of consents found in a consent statement

TypeCodeableConcept
Summarytrue
10. Consent.category.coding
Definition

A reference to a code defined by a terminology system.

ShortCode defined by a terminology system
Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Control0..*
TypeCoding
Summarytrue
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

12. Consent.category.coding.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

ShortSymbol in syntax defined by the system
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

Need to refer to a particular code in the system.

Fixed ValueDoss. delen?
14. Consent.patient
Definition

The patient/healthcare consumer to whom this consent applies.

ShortWho the consent applies to
Comments

Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

Control1..1
TypeReference(Patient, Patient)
Must Supporttrue
Summarytrue
16. Consent.period
Definition

Relevant time or time-period when this Consent is applicable.

ShortPeriod that this consent applies
Comments

This can be a subset of the period of the original statement.

Control0..1
TypePeriod
Must Supporttrue
Summarytrue
Meaning if Missingall date ranges included
18. Consent.organization
Definition

The organization that manages the consent, and the framework within which it is executed.

ShortCustodian of the consent
Control0..*
TypeReference(Organization, Organization)
Must Supporttrue
Summarytrue
Alternate Namescustodian
20. Consent.policy
Definition

The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

ShortPolicies covered by this consent
Control0..*
TypeBackboneElement
Must Supporttrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
22. Consent.policy.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
24. Consent.policy.uri
Definition

The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

ShortSpecific policy covered by this consent
Comments

This element is for discoverability / documentation, and does not modify or qualify the policy rules.

Control0..1
This element is affected by the following invariants: ppc-1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Fixed Valuehttps://rivo-noord.nl/zorgviewer/toestemming

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

0. Consent
Definition

A record of a healthcare consumer’s policy choices, which permits or denies identified recipient(s) or recipient role(s) to perform one or more actions within a given policy context, for specific purposes and periods of time.

ShortA healthcare consumer's policy choices to permits or denies recipients or roles to perform actions for specific purposes and periods of time
Comments

Broadly, there are 3 key areas of consent for patients: Consent around sharing information (aka Privacy Consent Directive - Authorization to Collect, Use, or Disclose information), consent for specific treatment, or kinds of treatment, and general advance care directives.

Control0..*
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())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
2. Consent.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. Consent.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. Consent.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. Consent.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. Consent.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. Consent.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. Consent.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. Consent.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. Consent.identifier
Definition

Unique identifier for this copy of the Consent Statement.

ShortIdentifier for this record (external references)
Comments

This identifier is identifies this copy of the consent. Where this identifier is also used elsewhere as the identifier for a consent record (e.g. a CDA consent document) then the consent details are expected to be the same.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Summarytrue
Example<br/><b>General</b>:{ "system" : "urn:ietf:rfc:3986", "value" : "Local eCMS identifier" }
20. Consent.status
Definition

Indicates the current state of this consent.

Shortdraft | proposed | active | rejected | inactive | entered-in-error
Comments

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.

Control1..1
BindingThe codes SHALL be taken from ConsentState
(required to http://hl7.org/fhir/ValueSet/consent-state-codes)

Indicates the state of the consent

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
Must Supporttrue
Summarytrue
Requirements

The Consent Directive that is pointed to might be in various lifecycle states, e.g., a revoked Consent Directive.

22. Consent.category
Definition

A classification of the type of consents found in the statement. This element supports indexing and retrieval of consent statements.

ShortClassification of the consent statement - for indexing/retrieval
Control0..*
BindingFor example codes, see Consent Category Codes
(example to http://hl7.org/fhir/ValueSet/consent-category)

A classification of the type of consents found in a consent statement

TypeCodeableConcept
Summarytrue
24. Consent.category.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.
26. Consent.category.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 Consent.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 28. Consent.category.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control0..*
    TypeCoding
    Summarytrue
    Requirements

    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

    30. Consent.category.coding.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.
    32. Consent.category.coding.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 Consent.category.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 34. Consent.category.coding.system
      Definition

      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

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

      Need to be unambiguous about the source of the definition of the symbol.

      36. Consent.category.coding.version
      Definition

      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

      ShortVersion of the system - if relevant
      Comments

      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

      NoteThis is a business version Id, not a resource version Id (see discussion)
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      38. Consent.category.coding.code
      Definition

      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortSymbol in syntax defined by the system
      Control0..1
      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

      Fixed ValueDoss. delen?
      40. Consent.category.coding.display
      Definition

      A representation of the meaning of the code in the system, following the rules of the system.

      ShortRepresentation defined by the system
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

      42. Consent.category.coding.userSelected
      Definition

      Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

      ShortIf this coding was chosen directly by the user
      Comments

      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

      44. Consent.category.text
      Definition

      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      ShortPlain text representation of the concept
      Comments

      Very often the text is the same as a displayName of one of the codings.

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

      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

      46. Consent.patient
      Definition

      The patient/healthcare consumer to whom this consent applies.

      ShortWho the consent applies to
      Comments

      Commonly, the patient the consent pertains to is the author, but for young and old people, it may be some other person.

      Control1..1
      TypeReference(Patient)
      Must Supporttrue
      Summarytrue
      48. Consent.period
      Definition

      Relevant time or time-period when this Consent is applicable.

      ShortPeriod that this consent applies
      Comments

      This can be a subset of the period of the original statement.

      Control0..1
      TypePeriod
      Must Supporttrue
      Summarytrue
      Meaning if Missingall date ranges included
      50. Consent.dateTime
      Definition

      When this Consent was issued / created / indexed.

      ShortWhen this Consent was created or indexed
      Comments

      This is not the time of the original consent, but the time that this statement was made or derived.

      Control0..1
      TypedateTime
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      52. Consent.consentingParty
      Definition

      Either the Grantor, which is the entity responsible for granting the rights listed in a Consent Directive or the Grantee, which is the entity responsible for complying with the Consent Directive, including any obligations or limitations on authorizations and enforcement of prohibitions.

      ShortWho is agreeing to the policy and exceptions
      Comments

      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.

      Control0..*
      TypeReference(Organization, Patient, Practitioner, RelatedPerson)
      Summarytrue
      Alternate Namesconsentor
      54. Consent.actor
      Definition

      Who or what is controlled by this consent. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

      ShortWho|what controlled by this consent (or group, by role)
      Control0..*
      TypeBackboneElement
      Summarytrue
      Meaning if MissingThere is no specific actor associated with the consent
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      56. Consent.actor.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.
      58. Consent.actor.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
      60. Consent.actor.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
      62. Consent.actor.role
      Definition

      How the individual is involved in the resources content that is described in the consent.

      ShortHow the actor is involved
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from SecurityRoleType
      (extensible to http://hl7.org/fhir/ValueSet/security-role-type)

      How an actor is involved in the consent considerations

      TypeCodeableConcept
      64. Consent.actor.reference
      Definition

      The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').

      ShortResource for the actor (or group, by role)
      Control1..1
      TypeReference(Device, Group, CareTeam, Organization, Patient, Practitioner, RelatedPerson)
      66. Consent.action
      Definition

      Actions controlled by this consent.

      ShortActions controlled by this consent
      Comments

      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'.

      Control0..*
      BindingFor example codes, see Consent Action Codes
      (example to http://hl7.org/fhir/ValueSet/consent-action)

      Detailed codes for the consent action.

      TypeCodeableConcept
      Summarytrue
      Meaning if Missingall actions
      68. Consent.organization
      Definition

      The organization that manages the consent, and the framework within which it is executed.

      ShortCustodian of the consent
      Control0..*
      TypeReference(Organization)
      Must Supporttrue
      Summarytrue
      Alternate Namescustodian
      70. Consent.source[x]
      Definition

      The source on which this consent statement is based. The source might be a scanned original paper form, or a reference to a consent that links back to such a source, a reference to a document repository (e.g. XDS) that stores the original consent document.

      ShortSource from which this consent is taken
      Comments

      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.

      Control0..1
      TypeChoice of: Attachment, Identifier, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Summarytrue
      72. Consent.policy
      Definition

      The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

      ShortPolicies covered by this consent
      Control0..*
      TypeBackboneElement
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      74. Consent.policy.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.
      76. Consent.policy.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
      78. Consent.policy.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
      80. Consent.policy.authority
      Definition

      Entity or Organization having regulatory jurisdiction or accountability for  enforcing policies pertaining to Consent Directives.

      ShortEnforcement source for policy
      Control0..1
      This element is affected by the following invariants: ppc-1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      82. Consent.policy.uri
      Definition

      The references to the policies that are included in this consent scope. Policies may be organizational, but are often defined jurisdictionally, or in law.

      ShortSpecific policy covered by this consent
      Comments

      This element is for discoverability / documentation, and does not modify or qualify the policy rules.

      Control0..1
      This element is affected by the following invariants: ppc-1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Fixed Valuehttps://rivo-noord.nl/zorgviewer/toestemming
      84. Consent.policyRule
      Definition

      A referece to the specific computable policy.

      ShortPolicy that this consents to
      Comments

      If the policy reference is not known, the resource cannot be processed. Where the reference is absent, there is no particular policy other than what is expressed directly in the consent resource.

      Control0..1
      This element is affected by the following invariants: ppc-1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Might be a unique identifier of a policy set in XACML, or other rules engine.

      86. Consent.securityLabel
      Definition

      A set of security labels that define which resources are controlled by this consent. If more than one label is specified, all resources must have all the specified labels.

      ShortSecurity Labels that define affected resources
      Comments

      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. Not all of the security labels make sense for use in this element (may define a narrower value set?).

      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from All Security Labels
      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

      Security Labels from the Healthcare Privacy and Security Classification System.

      TypeCoding
      Summarytrue
      88. Consent.purpose
      Definition

      The context of the activities a user is taking - why the user is accessing the data - that are controlled by this consent.

      ShortContext of activities for which the agreement is made
      Comments

      This element is for discoverability / documentation, and does not modify or qualify the policy (e.g. the policy itself describes the purposes for which it applies).

      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
      (extensible to http://hl7.org/fhir/ValueSet/v3-PurposeOfUse)

      What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels

      TypeCoding
      Summarytrue
      90. Consent.dataPeriod
      Definition

      Clinical or Operational Relevant period of time that bounds the data controlled by this consent.

      ShortTimeframe for data controlled by this consent
      Comments

      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.

      Control0..1
      TypePeriod
      Summarytrue
      92. Consent.data
      Definition

      The resources controlled by this consent, if specific resources are referenced.

      ShortData controlled by this consent
      Control0..*
      TypeBackboneElement
      Summarytrue
      Meaning if Missingall data
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      94. Consent.data.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.
      96. Consent.data.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
      98. Consent.data.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
      100. Consent.data.meaning
      Definition

      How the resource reference is interpreted when testing consent restrictions.

      Shortinstance | related | dependents | authoredby
      Control1..1
      BindingThe codes SHALL be taken from ConsentDataMeaning
      (required to http://hl7.org/fhir/ValueSet/consent-data-meaning)

      How a resource reference is interpreted when testing consent restrictions

      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      102. Consent.data.reference
      Definition

      A reference to a specific resource that defines which resources are covered by this consent.

      ShortThe actual data reference
      Control1..1
      TypeReference(Resource)
      Summarytrue
      104. Consent.except
      Definition

      An exception to the base policy of this consent. An exception can be an addition or removal of access permissions.

      ShortAdditional rule - addition or removal of permissions
      Control0..*
      TypeBackboneElement
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      106. Consent.except.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.
      108. Consent.except.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
      110. Consent.except.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
      112. Consent.except.type
      Definition

      Action to take - permit or deny - when the exception conditions are met.

      Shortdeny | permit
      Control1..1
      BindingThe codes SHALL be taken from ConsentExceptType
      (required to http://hl7.org/fhir/ValueSet/consent-except-type)

      How an exception statement is applied, such as adding additional consent or removing consent

      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      114. Consent.except.period
      Definition

      The timeframe in this exception is valid.

      ShortTimeframe for this exception
      Control0..1
      TypePeriod
      Summarytrue
      116. Consent.except.actor
      Definition

      Who or what is controlled by this Exception. Use group to identify a set of actors by some property they share (e.g. 'admitting officers').

      ShortWho|what controlled by this exception (or group, by role)
      Control0..*
      TypeBackboneElement
      Summarytrue
      Meaning if MissingThere is no specific actor associated with the exception
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      118. Consent.except.actor.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.
      120. Consent.except.actor.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
      122. Consent.except.actor.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
      124. Consent.except.actor.role
      Definition

      How the individual is involved in the resources content that is described in the exception.

      ShortHow the actor is involved
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from SecurityRoleType
      (extensible to http://hl7.org/fhir/ValueSet/security-role-type)

      How an actor is involved in the consent considerations

      TypeCodeableConcept
      126. Consent.except.actor.reference
      Definition

      The resource that identifies the actor. To identify a actors by type, use group to identify a set of actors by some property they share (e.g. 'admitting officers').

      ShortResource for the actor (or group, by role)
      Control1..1
      TypeReference(Device, Group, CareTeam, Organization, Patient, Practitioner, RelatedPerson)
      128. Consent.except.action
      Definition

      Actions controlled by this Exception.

      ShortActions controlled by this exception
      Comments

      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'.

      Control0..*
      BindingFor example codes, see Consent Action Codes
      (example to http://hl7.org/fhir/ValueSet/consent-action)

      Detailed codes for the consent action.

      TypeCodeableConcept
      Summarytrue
      Meaning if Missingall actions
      130. Consent.except.securityLabel
      Definition

      A set of security labels that define which resources are controlled by this exception. If more than one label is specified, all resources must have all the specified labels.

      ShortSecurity Labels that define affected resources
      Comments

      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. Not all of the security labels make sense for use in this element (may define a narrower value set?).

      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from All Security Labels
      (extensible to http://hl7.org/fhir/ValueSet/security-labels)

      Security Labels from the Healthcare Privacy and Security Classification System.

      TypeCoding
      Summarytrue
      132. Consent.except.purpose
      Definition

      The context of the activities a user is taking - why the user is accessing the data - that are controlled by this exception.

      ShortContext of activities covered by this exception
      Comments

      E.g. if the purpose is 'research', then the operational context must be research, in order for the consent to apply. Not all of the security labels make sense for use in this element (may define a narrower value set?).

      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
      (extensible to http://hl7.org/fhir/ValueSet/v3-PurposeOfUse)

      What purposes of use are controlled by this exception. If more than one label is specified, operations must have all the specified labels

      TypeCoding
      Summarytrue
      134. Consent.except.class
      Definition

      The class of information covered by this exception. The type can be a FHIR resource type, a profile on a type, or a CDA document, or some other type that indicates what sort of information the consent relates to.

      Shorte.g. Resource Type, Profile, or CDA etc
      Comments

      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.

      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from Consent Content Class
      (extensible to http://hl7.org/fhir/ValueSet/consent-content-class)

      The class (type) of information a consent rule covers

      TypeCoding
      Summarytrue
      136. Consent.except.code
      Definition

      If this code is found in an instance, then the exception applies.

      Shorte.g. LOINC or SNOMED CT code, etc in the content
      Comments

      Typical use of this is a Document code with class = CDA.

      Control0..*
      BindingFor example codes, see Consent Content Codes
      (example to http://hl7.org/fhir/ValueSet/consent-content-code)

      If this code is found in an instance, then the exception applies

      TypeCoding
      Summarytrue
      138. Consent.except.dataPeriod
      Definition

      Clinical or Operational Relevant period of time that bounds the data controlled by this exception.

      ShortTimeframe for data controlled by this exception
      Comments

      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.

      Control0..1
      TypePeriod
      Summarytrue
      140. Consent.except.data
      Definition

      The resources controlled by this exception, if specific resources are referenced.

      ShortData controlled by this exception
      Control0..*
      TypeBackboneElement
      Summarytrue
      Meaning if Missingall data
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      142. Consent.except.data.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.
      144. Consent.except.data.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
      146. Consent.except.data.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
      148. Consent.except.data.meaning
      Definition

      How the resource reference is interpreted when testing consent restrictions.

      Shortinstance | related | dependents | authoredby
      Control1..1
      BindingThe codes SHALL be taken from ConsentDataMeaning
      (required to http://hl7.org/fhir/ValueSet/consent-data-meaning)

      How a resource reference is interpreted when testing consent restrictions

      Typecode
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      150. Consent.except.data.reference
      Definition

      A reference to a specific resource that defines which resources are covered by this consent.

      ShortThe actual data reference
      Control1..1
      TypeReference(Resource)
      Summarytrue