Standard Health Record FHIR Implementation Guide

SHR Organization Profile - Detailed Descriptions

Definitions for shr-entity-Organization.

Organization
Definition

A social or legal structure formed by human beings.

Control0..*
InvariantsDefined on this element
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
org-1: The organization SHALL at least have a name or an id, and possibly more than one (: (identifier.count() + name.count()) > 0)
Organization.id
Definition

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

Control0..1
Typeid
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.

Organization.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.

Control0..1
TypeMeta
Organization.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.

Control0..1
Typeuri
Is Modifiertrue
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.

Organization.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Typecode
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).

Organization.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.

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

Organization.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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

Organization.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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Organization.extension (http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension)
Definition

If content was generated during a patient encounter, related encounter is the encounter where the information was gained.

Control0..* This element is affected by the following invariants: ele-1
Type (Extension Type: Reference(SHR EncounterPerformed Profile))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: children().count() > id.count())
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Organization.extension (http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension)
Definition

The person or organization who created the entry and is responsible for (and may certify) the content.

Control0..* This element is affected by the following invariants: ele-1
Type (Extension Type: Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta)
InvariantsDefined on this element
choice-1: shr-base-Author-extension SHALL have either extension('string') or extension('patient') or extension('group') or extension('device') or extension('participant') or extension('relatedperson') or extension('organization') (: ( extension('string').url | extension('patient').url | extension('group').url | extension('device').url | extension('participant').url | extension('relatedperson').url | extension('organization').url ).distinct().count() == 1)
ele-1: All FHIR elements must have a @value or children (: children().count() > id.count())
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Organization.extension (http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension)
Definition

The person or entity that provided the information in the entry, as distinct from who created the entry, e.g. the subject (patient), medical professional, family member, device or software program.

Control0..* This element is affected by the following invariants: ele-1
Type (Extension Type: Choice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta)
InvariantsDefined on this element
choice-1: shr-base-Informant-extension SHALL have either extension('string') or extension('patient') or extension('group') or extension('device') or extension('participant') or extension('relatedperson') or extension('organization') (: ( extension('string').url | extension('patient').url | extension('group').url | extension('device').url | extension('participant').url | extension('relatedperson').url | extension('organization').url ).distinct().count() == 1)
ele-1: All FHIR elements must have a @value or children (: children().count() > id.count())
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Organization.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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

Organization.identifier
Definition

Identifier for the organization that is used to identify the organization across multiple disparate systems.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control1..* This element is affected by the following invariants: org-1
TypeIdentifier(SHR OrganizationIdentifier Profile)
Must Supporttrue
Requirements

Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

Organization.identifier.id
Definition

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

Control0..1
Typestring
Organization.identifier.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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Organization.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

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

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.

Organization.identifier.type
Definition

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

Control0..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

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

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.

Organization.identifier.system
Definition

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

Control1..1
Typeuri
Must Supporttrue
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.

Comments

NPI preferred (http://hl7.org/fhir/sid/us-npi), Tax id is allowed (http://hl7.org/fhir/sid/us-tin), Local id is allowed in addition to 'authoritative' identifier.

Example
General:http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri
Organization.identifier.value
Definition

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

Control0..1
Typestring
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.

Example
General:123456
Organization.identifier.period
Definition

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

Control0..1
TypePeriod
Organization.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
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.

Organization.active
Definition

Whether the organization's record is still in active use.

Control1..1
Typeboolean
Is Modifiertrue
Must Supporttrue
Requirements

Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

Comments

Default is true.

This active flag is not intended to be used to mark an organizations as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.

This element is labeled as a modifier because it may be used to mark that the resource was created in error.

Default Valuetrue
Organization.type
Definition

The kind(s) of organization that this is.

Control1..1
BindingUsed to categorize the organization
The codes SHALL be taken from OrganizationType
TypeCodeableConcept
Requirements

Need to be able to track the kind of organization that this is - different organization types have different uses.

Comments

Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

We expect that some jurisdictions will profile this optionality to be a single cardinality.

Organization.name
Definition

A name associated with the organization.

Control1..1 This element is affected by the following invariants: org-1
Typestring
Must Supporttrue
Requirements

Need to use the name as the label of the organization.

Comments

If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.

Organization.alias
Definition

A list of alternate names that the organization is known as, or was known as in the past.

Control0..*
Typestring
Requirements

Over time locations and organizations go through many changes and can be known by different names.

For searching knowing previous names that the organization was known by can be very useful.

Comments

There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.

Organization.telecom
Definition

A contact detail for the organization.

Control1..* This element is affected by the following invariants: org-3
TypeContactPoint
Must Supporttrue
Requirements

Human contact for the organization.

Comments

The use code home is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

InvariantsDefined on this element
org-3: The telecom of an organization can never be of use 'home' (: where(use = 'home').empty())
Organization.address
Definition

An address for the organization.

Control1..* This element is affected by the following invariants: org-2
TypeAddress(SHR Address Profile)
Must Supporttrue
Requirements

May need to keep track of the organization's addresses for contacting, billing or reporting requirements.

Comments

Organization may have multiple addresses with different uses or applicable periods. The use code home is not to be used.

InvariantsDefined on this element
org-2: An address of an organization can never be of use 'home' (: where(use = 'home').empty())
Organization.address.id
Definition

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

Control0..1
Typestring
Organization.address.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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Organization.address.use
Definition

The purpose of this address.

Control0..1
BindingThe use of an address
The codes SHALL be taken from AddressUse
Typecode
Is Modifiertrue
Requirements

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

Comments

This is labeled as "Is Modifier" because applications should not mistake a temporary or old address etc.for a current/permanent one. Applications can assume that an address is current unless it explicitly says that it is temporary or old.

Example
General:home
Organization.address.type
Definition

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

Control0..1
BindingThe type of an address (physical / postal)
The codes SHALL be taken from AddressType
Typecode
Example
General:both
Organization.address.text
Definition

A full text representation of the address.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts.

Example
General:137 Nowhere Street, Erewhon 9132
Organization.address.line
Definition

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

Control0..*
Typestring
Must Supporttrue
Requirements

home | work | temp | old - purpose of this address.

Example
General:137 Nowhere Street
Organization.address.city
Definition

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

Control0..1
Typestring
Must Supporttrue
Alternate NamesMunicpality
Example
General:Erewhon
Organization.address.district
Definition

The name of the administrative area (county).

Control0..1
Typestring
Alternate NamesCounty
Comments

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

Example
General:Madison
Organization.address.state
Definition

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

Control0..1
BindingTwo letter USPS alphabetic codes.
The codes SHALL be taken from USPS Two Letter Alphabetic Codes
Typestring
Must Supporttrue
Alternate NamesProvince, Territory
Organization.address.postalCode
Definition

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

Control0..1
Typestring
Must Supporttrue
Alternate NamesZip
Example
General:9132
Organization.address.country
Definition

Country - a nation as commonly understood or generally accepted.

Control0..1
Typestring
Comments

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

Organization.address.period
Definition

Time period when address was/is in use.

Control0..1
TypePeriod
Requirements

Allows addresses to be placed in historical context.

Example
General:<valuePeriod xmlns="http://hl7.org/fhir">
  <start value="2010-03-23T00:00:00+11:00"/>
  <end value="2010-07-01T00:00:00+10:00"/>
</valuePeriod>
Organization.partOf
Definition

The organization of which this organization forms a part.

Control0..1
TypeReference(SHR Organization Profile)
Requirements

Need to be able to track the hierarchy of organizations within an organization.

Organization.contact
Definition

Contact for the organization for a certain purpose.

Control1..*
TypeBackboneElement
Requirements

Need to keep track of assigned contact points within bigger organization.

Comments

Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count()))
Organization.contact.id
Definition

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

Control0..1
Typestring
Organization.contact.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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Organization.contact.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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

Organization.contact.purpose
Definition

Indicates a purpose for which the contact can be reached.

Control0..1
BindingThe purpose for which you would contact a contact party
The codes SHALL be taken from ContactEntityType; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Need to distinguish between multiple contact persons.

Organization.contact.name
Definition

A name associated with the contact.

Control0..1
TypeHumanName
Requirements

Need to be able to track the person by name.

Organization.contact.telecom
Definition

A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

Control0..*
TypeContactPoint
Requirements

People have (primary) ways to contact them in some way such as phone, email.

Organization.contact.address
Definition

Visiting or postal addresses for the contact.

Control0..1
TypeAddress
Requirements

May need to keep track of a contact party's address for contacting, billing or reporting requirements.

Organization.endpoint
Definition

Technical endpoints providing access to services operated for the organization.

Control0..*
TypeReference(Endpoint)
Must Supporttrue
Requirements

Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.