NZ Shared Digital Health Record API
0.6.0 - ballot

NZ Shared Digital Health Record API - Local Development build (v0.6.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: SDHRConsent - Detailed Descriptions

Draft as of 2025-08-07

Definitions for the SDHRConsent resource profile.

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

0. Consent
Definition

A record of a healthcare consumer’s 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 choices to permit or deny 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..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

Indicates the current state of this consent.

ShortThe state of the Consent. This must be active to release data from the serverdraft | 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|4.0.1
(required to http://hl7.org/fhir/ValueSet/consent-state-codes|4.0.1)

Indicates the state of the consent.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

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

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

A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible.

ShortWhich of the four areas this resource covers (extensible)
Control1..1
BindingUnless not suitable, these codes SHALL be taken from ConsentScopeCodeshttp://hl7.org/fhir/ValueSet/consent-scope
(extensible to http://hl7.org/fhir/ValueSet/consent-scope)

The four anticipated uses for the Consent Resource.

TypeCodeableConcept
Is Modifiertrue because Allows changes to codes based on scope selection
Summarytrue
Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
    "code" : "patient-privacy"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Consent.category
Definition

The category of the consent, which is a code that indicates the type of consent


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

ShortThe category of the consent, which is a code that indicates the type of consentClassification of the consent statement - for indexing/retrieval
Control1..1*
BindingUnless not suitable, these codes SHALL be taken from ConsentCategoryCodeshttp://hl7.org/fhir/ValueSet/consent-category
(extensible to http://hl7.org/fhir/ValueSet/consent-category)

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

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Fixed Value{
  "coding" : [{
    "system" : "http://snomed.info/sct",
    "code" : "887031000000108"
  }]
}
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. 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.

Control10..1
TypeReference(Patient)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Consent.patient.reference
Definition

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

ShortMust be an absolute URL reference to the patient on the NHI system. See constraints for details.Literal reference, Relative, internal or absolute URL
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control10..1
This element is affected by the following invariants: ref-1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
nhi-url-format: Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA (matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$'))
16. Consent.patient.type
Definition

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

ShortType the reference refers to (e.g. "Patient")
Comments

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Control10..1
BindingUnless not suitable, these codes SHALL be taken from ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
(extensible to http://hl7.org/fhir/ValueSet/resource-types)

Aa resource (or, for logical models, the URI of the logical model).

Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Pattern ValuePatient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. 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
Control10..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

ShortThe provision of the consent, which may be a permit or denyConstraints to the base Consent.policyRule
Control10..1
TypeBackboneElement
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Consent.provision.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

ShortThe type of consent, either permit or denydeny | permit
Control10..1
BindingThe codes SHALL be taken from ConsentProvisionTypehttp://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1)

How a rule statement is applied, such as adding additional consent or removing consent.

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

Actions controlled by this Rule.

ShortThe action that is being permitted or deniedActions controlled by this rule
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'.

Control10..*
BindingFor example codes, see ConsentActionCodeshttp://hl7.org/fhir/ValueSet/consent-action
(example to http://hl7.org/fhir/ValueSet/consent-action)

Detailed codes for the consent action.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Meaning if Missingall actions
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Consent.provision.provision
Definition

Rules which provide exceptions to the base rule or subrules.

ShortNested Exception Rules
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Consent.provision.provision.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

    Indicates whether the patient has opted out or opted in to participation at the facility. If opted out, no records will be shared from that facility.

    ShortIndicates the patient has opted out of participation entirely at the facility
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Facility Participation) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    36. Consent.provision.provision.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

    0. Consent
    2. Consent.status
    ShortThe state of the Consent. This must be active to release data from the server
    4. Consent.scope
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
        "code" : "patient-privacy"
      }]
    }
    6. Consent.category
    Definition

    The category of the consent, which is a code that indicates the type of consent

    ShortThe category of the consent, which is a code that indicates the type of consent
    Control0..1
    Fixed Value{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "887031000000108"
      }]
    }
    8. Consent.patient
    Control1..?
    10. Consent.patient.reference
    ShortMust be an absolute URL reference to the patient on the NHI system. See constraints for details.
    Control1..?
    Invariantsnhi-url-format: Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA (matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$'))
    12. Consent.patient.type
    Control1..?
    Pattern ValuePatient
    14. Consent.policy
    Control1..?
    16. Consent.provision
    ShortThe provision of the consent, which may be a permit or deny
    Control1..?
    18. Consent.provision.type
    ShortThe type of consent, either permit or deny
    Control1..?
    20. Consent.provision.period
    22. Consent.provision.period.start
    ShortThe date and time the Consent is considered to be in effect
    Control1..?
    24. Consent.provision.period.end
    ShortThe date and time the Consent is considered to be expired
    26. Consent.provision.action
    ShortThe action that is being permitted or denied
    Control1..?
    28. Consent.provision.provision
    TypeBackboneElement
    30. Consent.provision.provision.extension
    SlicingThis element introduces a set of slices on Consent.provision.provision.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 32. Consent.provision.provision.extension:FacilityParticipationExtension
      Slice NameFacilityParticipationExtension
      ShortIndicates the patient has opted out of participation entirely at the facility
      Control0..1
      TypeExtension(Facility Participation) (Extension Type: CodeableConcept)

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

      0. Consent
      Definition

      A record of a healthcare consumer’s 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 choices to permit or deny 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..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      ppc-1: Either a Policy or PolicyRule (policy.exists() or policyRule.exists())
      ppc-2: IF Scope=privacy, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='patient-privacy').exists().not())
      ppc-3: IF Scope=research, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='research').exists().not())
      ppc-4: IF Scope=adr, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='adr').exists().not())
      ppc-5: IF Scope=treatment, there must be a patient (patient.exists() or scope.coding.where(system='something' and code='treatment').exists().not())
      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
      Is Modifierfalse
      Summarytrue
      4. Consent.meta
      Definition

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

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. 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
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

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

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      16. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

      Unique identifier for this copy of the Consent Statement.

      ShortIdentifier for this record (external references)
      Comments

      This identifier 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..*
      TypeIdentifier
      Is Modifierfalse
      Summarytrue
      Example<br/><b>General</b>:{ "system" : "http://acme.org/identifier/local/eCMS", "value" : "Local eCMS identifier" }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Consent.status
      Definition

      Indicates the current state of this consent.

      ShortThe state of the Consent. This must be active to release data from the server
      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|4.0.1)

      Indicates the state of the consent.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

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

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

      A selector of the type of consent being presented: ADR, Privacy, Treatment, Research. This list is now extensible.

      ShortWhich of the four areas this resource covers (extensible)
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from ConsentScopeCodes
      (extensible to http://hl7.org/fhir/ValueSet/consent-scope)

      The four anticipated uses for the Consent Resource.

      TypeCodeableConcept
      Is Modifiertrue because Allows changes to codes based on scope selection
      Summarytrue
      Pattern Value{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
          "code" : "patient-privacy"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Consent.category
      Definition

      The category of the consent, which is a code that indicates the type of consent

      ShortThe category of the consent, which is a code that indicates the type of consent
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from ConsentCategoryCodes
      (extensible to http://hl7.org/fhir/ValueSet/consent-category)

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

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Fixed Value{
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "887031000000108"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. 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)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Consent.patient.id
      Definition

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

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

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

        ShortMust be an absolute URL reference to the patient on the NHI system. See constraints for details.
        Comments

        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

        Control1..1
        This element is affected by the following invariants: ref-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        nhi-url-format: Reference must be an NHI Patient URL with format https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/ZZZ1111 or ZZZ11AA (matches('^https://api.hip.digital.health.nz/fhir/nhi/v1/Patient/[A-Z]{3}([0-9]{4}|[0-9]{2}[A-Z]{2})$'))
        34. Consent.patient.type
        Definition

        The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

        The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

        ShortType the reference refers to (e.g. "Patient")
        Comments

        This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from ResourceType
        (extensible to http://hl7.org/fhir/ValueSet/resource-types)

        Aa resource (or, for logical models, the URI of the logical model).

        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Pattern ValuePatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Consent.patient.identifier
        Definition

        An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

        ShortLogical reference, when literal reference is not known
        Comments

        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

        Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Consent.patient.display
        Definition

        Plain text narrative that identifies the resource in addition to the resource reference.

        ShortText alternative for the resource
        Comments

        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. 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
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Consent.performer
        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 rules
        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, PractitionerRole)
        Is Modifierfalse
        Summarytrue
        Alternate Namesconsentor
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Consent.organization
        Definition

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

        ShortCustodian of the consent
        Control0..*
        TypeReference(Organization)
        Is Modifierfalse
        Summarytrue
        Alternate Namescustodian
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. 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, Reference(Consent, DocumentReference, Contract, QuestionnaireResponse)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. 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
        Control1..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. 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.

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

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        54. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        56. 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
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. 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
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Consent.policyRule
        Definition

        A reference to the specific base computable regulation or policy.

        ShortRegulation that this consents to
        Comments

        If the policyRule is absent, computable consent would need to be constructed from the elements of the Consent resource.

        Control0..1
        This element is affected by the following invariants: ppc-1
        BindingUnless not suitable, these codes SHALL be taken from ConsentPolicyRuleCodes
        (extensible to http://hl7.org/fhir/ValueSet/consent-policy)

        Regulatory policy examples.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

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

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

        Whether a treatment instruction (e.g. artificial respiration yes or no) was verified with the patient, his/her family or another authorized person.

        ShortConsent Verified by patient or family
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Consent.verification.id
        Definition

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

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

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

        Has the instruction been verified.

        ShortHas been verified
        Control1..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Consent.verification.verifiedWith
        Definition

        Who verified the instruction (Patient, Relative or other Authorized Person).

        ShortPerson who verified
        Control0..1
        TypeReference(Patient, RelatedPerson)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Consent.verification.verificationDate
        Definition

        Date verification was collected.

        ShortWhen consent verified
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. Consent.provision
        Definition

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

        ShortThe provision of the consent, which may be a permit or deny
        Control1..1
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Consent.provision.id
        Definition

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

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

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

        Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

        ShortThe type of consent, either permit or deny
        Control1..1
        BindingThe codes SHALL be taken from ConsentProvisionType
        (required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1)

        How a rule statement is applied, such as adding additional consent or removing consent.

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

        The timeframe in this rule is valid.

        ShortTimeframe for this rule
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        88. Consent.provision.period.id
        Definition

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

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

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          The start of the period. The boundary is inclusive.

          ShortThe date and time the Consent is considered to be in effect
          Comments

          If the low element is missing, the meaning is that the low boundary is not known.

          Control1..1
          This element is affected by the following invariants: per-1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. Consent.provision.period.end
          Definition

          The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

          ShortThe date and time the Consent is considered to be expired
          Comments

          The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

          Control0..1
          This element is affected by the following invariants: per-1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Meaning if MissingIf the end of the period is missing, it means that the period is ongoing
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. Consent.provision.actor
          Definition

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

          ShortWho|what controlled by this rule (or group, by role)
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Meaning if MissingThere is no specific actor associated with the exception
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. Consent.provision.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.

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

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          102. Consent.provision.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          104. Consent.provision.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
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          106. Consent.provision.actor.reference
          Definition

          The resource that identifies the actor. To identify 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, PractitionerRole)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. Consent.provision.action
          Definition

          Actions controlled by this Rule.

          ShortThe action that is being permitted or denied
          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'.

          Control1..*
          BindingFor example codes, see ConsentActionCodes
          (example to http://hl7.org/fhir/ValueSet/consent-action)

          Detailed codes for the consent action.

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Meaning if Missingall actions
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. Consent.provision.securityLabel
          Definition

          A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.

          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. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

          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
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          112. Consent.provision.purpose
          Definition

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

          ShortContext of activities covered by this rule
          Comments

          When the purpose of use tag is on the data, access request purpose of use shall not conflict.

          Control0..*
          BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
          (extensible to http://terminology.hl7.org/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
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          114. Consent.provision.class
          Definition

          The class of information covered by this rule. 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, 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 ConsentContentClass
          (extensible to http://hl7.org/fhir/ValueSet/consent-content-class)

          The class (type) of information a consent rule covers.

          TypeCoding
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          116. Consent.provision.code
          Definition

          If this code is found in an instance, then the rule 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 ConsentContentCodes
          (example to http://hl7.org/fhir/ValueSet/consent-content-code)

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

          TypeCodeableConcept
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          118. Consent.provision.dataPeriod
          Definition

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

          ShortTimeframe for data controlled by this rule
          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
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          120. Consent.provision.data
          Definition

          The resources controlled by this rule if specific resources are referenced.

          ShortData controlled by this rule
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summarytrue
          Meaning if Missingall data
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          122. Consent.provision.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.

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

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          126. Consent.provision.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          128. Consent.provision.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|4.0.1)

          How a resource reference is interpreted when testing consent restrictions.

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

          Rules which provide exceptions to the base rule or subrules.

          ShortNested Exception Rules
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          134. Consent.provision.provision.id
          Definition

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

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

          An Extension

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

            Indicates whether the patient has opted out or opted in to participation at the facility. If opted out, no records will be shared from that facility.

            ShortIndicates the patient has opted out of participation entirely at the facility
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Facility Participation) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            140. Consent.provision.provision.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

            Action to take - permit or deny - when the rule conditions are met. Not permitted in root rule, required in all nested rules.

            Shortdeny | permit
            Control0..1
            BindingThe codes SHALL be taken from ConsentProvisionType
            (required to http://hl7.org/fhir/ValueSet/consent-provision-type|4.0.1)

            How a rule statement is applied, such as adding additional consent or removing consent.

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

            The timeframe in this rule is valid.

            ShortTimeframe for this rule
            Control0..1
            TypePeriod
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            146. Consent.provision.provision.actor
            Definition

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

            ShortWho|what controlled by this rule (or group, by role)
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Meaning if MissingThere is no specific actor associated with the exception
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. Consent.provision.provision.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.

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

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            152. Consent.provision.provision.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            154. Consent.provision.provision.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
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            156. Consent.provision.provision.actor.reference
            Definition

            The resource that identifies the actor. To identify 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, PractitionerRole)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            158. Consent.provision.provision.action
            Definition

            Actions controlled by this Rule.

            ShortActions controlled by this rule
            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 ConsentActionCodes
            (example to http://hl7.org/fhir/ValueSet/consent-action)

            Detailed codes for the consent action.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Meaning if Missingall actions
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            160. Consent.provision.provision.securityLabel
            Definition

            A security label, comprised of 0..* security label fields (Privacy tags), which define which resources are controlled by this exception.

            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. When the purpose of use tag is on the data, access request purpose of use shall not conflict.

            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
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            162. Consent.provision.provision.purpose
            Definition

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

            ShortContext of activities covered by this rule
            Comments

            When the purpose of use tag is on the data, access request purpose of use shall not conflict.

            Control0..*
            BindingUnless not suitable, these codes SHALL be taken from PurposeOfUse
            (extensible to http://terminology.hl7.org/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
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            164. Consent.provision.provision.class
            Definition

            The class of information covered by this rule. 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, 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 ConsentContentClass
            (extensible to http://hl7.org/fhir/ValueSet/consent-content-class)

            The class (type) of information a consent rule covers.

            TypeCoding
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            166. Consent.provision.provision.code
            Definition

            If this code is found in an instance, then the rule 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 ConsentContentCodes
            (example to http://hl7.org/fhir/ValueSet/consent-content-code)

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

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            168. Consent.provision.provision.dataPeriod
            Definition

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

            ShortTimeframe for data controlled by this rule
            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
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            170. Consent.provision.provision.data
            Definition

            The resources controlled by this rule if specific resources are referenced.

            ShortData controlled by this rule
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summarytrue
            Meaning if Missingall data
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            172. Consent.provision.provision.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.

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

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            176. Consent.provision.provision.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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            178. Consent.provision.provision.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|4.0.1)

            How a resource reference is interpreted when testing consent restrictions.

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

            Rules which provide exceptions to the base rule or subrules.

            ShortNested Exception Rules
            Control0..*
            TypeSeettp://hl7.org/fhir/StructureDefinition/Consent#Consent.provision
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))