Advance Care Planning (PZP)
1.0.0-rc2 - trial-use

This page is part of the Advance Care Planning (PZP) (v1.0.0-rc2: Release 1) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

Resource Profile: ACPInformRelativesRequest - Detailed Descriptions

Draft as of 2026-03-03

Definitions for the ACP-InformRelativesRequest resource profile.

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

0. CommunicationRequest
Definition

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

ShortA request for information to be sent to a receiver
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())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource 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())
2. CommunicationRequest.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()))
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. CommunicationRequest.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())
ele-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. CommunicationRequest.status
Definition

The status of the proposal or order.

Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
Control1..1
BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

The status of the communication request.

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

The type of message to be sent such as alert, notification, reminder, instruction, etc.

ShortMessage category
Comments

The category.text element may be used to provide additional context for human readers next to the pattern category coding, for example: 'Request for patient to inform relatives about treatment agreements'.


There may be multiple axes of categorization and one communication request may serve multiple purposes.

Control10..*
BindingFor example codes, see CommunicationCategoryhttp://hl7.org/fhir/ValueSet/communication-category|4.0.1
(example to http://hl7.org/fhir/ValueSet/communication-category|4.0.1)

Codes for general categories of communications such as alerts, instruction, etc.

TypeCodeableConcept
Is Modifierfalse
Obligations
    ObligationsActor
    SHALL:populate-if-knownACP Actor Provider
    SHALL:no-errorACP Actor Consulter
    Summaryfalse
    Pattern Value{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "223449006"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. CommunicationRequest.doNotPerform
    Definition

    If true indicates that the CommunicationRequest is asking for the specified action to not occur.

    ShortTrue if request is prohibiting action
    Comments

    The attributes provided with the request qualify what is not to be done.

    Control0..1
    Typeboolean
    Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Alternate Namesprohibited
    Meaning if MissingIf do not perform is not specified, the request is a positive request e.g. "do perform"
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. CommunicationRequest.subject
    Definition

    The patient or group that is the focus of this communication request.

    ShortFocus of message
    Control0..1
    TypeReference(ACP Patient, Patient, Group)
    Is Modifierfalse
    Obligations
      ObligationsActor
      SHALL:populate-if-knownACP Actor Provider
      SHALL:no-errorACP Actor Consulter
      Summaryfalse
      Alternate Namespatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. CommunicationRequest.encounter
      Definition

      The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.

      ShortEncounter created as part of
      Comments

      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

      Control0..1
      TypeReference(ACP Encounter, Encounter)
      Is Modifierfalse
      Obligations
        ObligationsActor
        SHALL:populate-if-knownACP Actor Provider
        SHALL:no-errorACP Actor Consulter
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. CommunicationRequest.authoredOn
        Definition

        For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.

        ShortWhen request transitioned to being actionable
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Obligations
          ObligationsActor
          SHALL:populate-if-knownACP Actor Provider
          SHALL:no-errorACP Actor Consulter
          Summarytrue
          Alternate NamescreatedOn
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          18. CommunicationRequest.requester
          Definition

          The device, individual, or organization who initiated the request and has responsibility for its activation.

          ShortWho/what is requesting service
          Control0..1
          TypeReference(ACP HealthProfessional PractitionerRole, ACP HealthProfessional Practitioner, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
          Is Modifierfalse
          Obligations
            ObligationsActor
            SHALL:populate-if-knownACP Actor Provider
            SHALL:no-errorACP Actor Consulter
            Summarytrue
            Alternate Namesauthor
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. CommunicationRequest.recipient
            Definition

            The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.

            ShortMessage recipient
            Control0..*
            TypeReference(ACP ContactPerson, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Group, CareTeam, HealthcareService)
            Is Modifierfalse
            Obligations
              ObligationsActor
              SHALL:populate-if-knownACP Actor Provider
              SHALL:no-errorACP Actor Consulter
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. CommunicationRequest.sender
              Definition

              The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.

              ShortMessage sender
              Control0..1
              TypeReference(ACP Patient, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService)
              Is Modifierfalse
              Obligations
                ObligationsActor
                SHALL:populate-if-knownACP Actor Provider
                SHALL:no-errorACP Actor Consulter
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                24. CommunicationRequest.reasonCode
                Definition

                Describes why the request is being made in coded or textual form.

                ShortWhy is communication needed?
                Comments

                Textual reasons can be captured using reasonCode.text.

                Control10..*
                BindingFor example codes, see ActReason (3.0.0)http://terminology.hl7.org/ValueSet/v3-ActReason
                (example to http://terminology.hl7.org/ValueSet/v3-ActReason|3.0.0)

                Codes for describing reasons for the occurrence of a communication.

                TypeCodeableConcept
                Is Modifierfalse
                Obligations
                  ObligationsActor
                  SHALL:populate-if-knownACP Actor Provider
                  SHALL:no-errorACP Actor Consulter
                  Summarytrue
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://snomed.info/sct",
                      "code" : "713603004"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                  0. CommunicationRequest
                  2. CommunicationRequest.category
                  Comments

                  The category.text element may be used to provide additional context for human readers next to the pattern category coding, for example: 'Request for patient to inform relatives about treatment agreements'.

                  Control1..?
                  Obligations
                    ObligationsActor
                    SHALL:populate-if-knownACP Actor Provider
                    SHALL:no-errorACP Actor Consulter
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://snomed.info/sct",
                        "code" : "223449006"
                      }]
                    }
                    4. CommunicationRequest.subject
                    TypeReference(ACP Patient)
                    Obligations
                      ObligationsActor
                      SHALL:populate-if-knownACP Actor Provider
                      SHALL:no-errorACP Actor Consulter
                      6. CommunicationRequest.encounter
                      TypeReference(ACP Encounter)
                      Obligations
                        ObligationsActor
                        SHALL:populate-if-knownACP Actor Provider
                        SHALL:no-errorACP Actor Consulter
                        8. CommunicationRequest.authoredOn
                        Obligations
                          ObligationsActor
                          SHALL:populate-if-knownACP Actor Provider
                          SHALL:no-errorACP Actor Consulter
                          10. CommunicationRequest.requester
                          TypeReference(ACP HealthProfessional PractitionerRole, ACP HealthProfessional Practitioner)
                          Obligations
                            ObligationsActor
                            SHALL:populate-if-knownACP Actor Provider
                            SHALL:no-errorACP Actor Consulter
                            12. CommunicationRequest.recipient
                            TypeReference(ACP ContactPerson)
                            Obligations
                              ObligationsActor
                              SHALL:populate-if-knownACP Actor Provider
                              SHALL:no-errorACP Actor Consulter
                              14. CommunicationRequest.sender
                              TypeReference(ACP Patient)
                              Obligations
                                ObligationsActor
                                SHALL:populate-if-knownACP Actor Provider
                                SHALL:no-errorACP Actor Consulter
                                16. CommunicationRequest.reasonCode
                                Control1..?
                                Obligations
                                  ObligationsActor
                                  SHALL:populate-if-knownACP Actor Provider
                                  SHALL:no-errorACP Actor Consulter
                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://snomed.info/sct",
                                      "code" : "713603004"
                                    }]
                                  }

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

                                  0. CommunicationRequest
                                  Definition

                                  A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

                                  ShortA request for information to be sent to a receiver
                                  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())
                                  2. CommunicationRequest.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. CommunicationRequest.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. CommunicationRequest.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. CommunicationRequest.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|4.0.1)

                                  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. CommunicationRequest.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. CommunicationRequest.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. CommunicationRequest.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. CommunicationRequest.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. CommunicationRequest.identifier
                                  Definition

                                  Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

                                  ShortUnique identifier
                                  Comments

                                  This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                  Control0..*
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  20. CommunicationRequest.basedOn
                                  Definition

                                  A plan or proposal that is fulfilled in whole or in part by this request.

                                  ShortFulfills plan or proposal
                                  Control0..*
                                  TypeReference(Resource)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.

                                  Alternate Namesfulfills
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  22. CommunicationRequest.replaces
                                  Definition

                                  Completed or terminated request(s) whose function is taken by this new request.

                                  ShortRequest(s) replaced by this request
                                  Comments

                                  The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.

                                  Control0..*
                                  TypeReference(CommunicationRequest)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

                                  Alternate Namessupersedes, prior
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  24. CommunicationRequest.groupIdentifier
                                  Definition

                                  A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.

                                  ShortComposite request this is part of
                                  Comments

                                  Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

                                  Control0..1
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Summarytrue
                                  Alternate NamesgrouperId
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  26. CommunicationRequest.status
                                  Definition

                                  The status of the proposal or order.

                                  Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
                                  Control1..1
                                  BindingThe codes SHALL be taken from RequestStatus
                                  (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

                                  The status of the communication request.

                                  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
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  28. CommunicationRequest.statusReason
                                  Definition

                                  Captures the reason for the current state of the CommunicationRequest.

                                  ShortReason for current status
                                  Comments

                                  This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].

                                  Control0..1
                                  Binding

                                  Codes identifying the reason for the current state of a request.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate NamesSuspended Reason, Cancelled Reason
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  30. CommunicationRequest.category
                                  Definition

                                  The type of message to be sent such as alert, notification, reminder, instruction, etc.

                                  ShortMessage category
                                  Comments

                                  The category.text element may be used to provide additional context for human readers next to the pattern category coding, for example: 'Request for patient to inform relatives about treatment agreements'.

                                  Control1..*
                                  BindingFor example codes, see CommunicationCategory
                                  (example to http://hl7.org/fhir/ValueSet/communication-category|4.0.1)

                                  Codes for general categories of communications such as alerts, instruction, etc.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Obligations
                                    ObligationsActor
                                    SHALL:populate-if-knownACP Actor Provider
                                    SHALL:no-errorACP Actor Consulter
                                    Summaryfalse
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://snomed.info/sct",
                                        "code" : "223449006"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    32. CommunicationRequest.priority
                                    Definition

                                    Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.

                                    Shortroutine | urgent | asap | stat
                                    Control0..1
                                    BindingThe codes SHALL be taken from RequestPriority
                                    (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

                                    Codes indicating the relative importance of a communication request.

                                    Typecode
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Meaning if MissingIf missing, this task should be performed with normal priority
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    34. CommunicationRequest.doNotPerform
                                    Definition

                                    If true indicates that the CommunicationRequest is asking for the specified action to not occur.

                                    ShortTrue if request is prohibiting action
                                    Comments

                                    The attributes provided with the request qualify what is not to be done.

                                    Control0..1
                                    Typeboolean
                                    Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Alternate Namesprohibited
                                    Meaning if MissingIf do not perform is not specified, the request is a positive request e.g. "do perform"
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    36. CommunicationRequest.medium
                                    Definition

                                    A channel that was used for this communication (e.g. email, fax).

                                    ShortA channel of communication
                                    Control0..*
                                    BindingFor example codes, see ParticipationMode (3.0.0)
                                    (example to http://terminology.hl7.org/ValueSet/v3-ParticipationMode|3.0.0)

                                    Codes for communication mediums such as phone, fax, email, in person, etc.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    38. CommunicationRequest.subject
                                    Definition

                                    The patient or group that is the focus of this communication request.

                                    ShortFocus of message
                                    Control0..1
                                    TypeReference(ACP Patient)
                                    Is Modifierfalse
                                    Obligations
                                      ObligationsActor
                                      SHALL:populate-if-knownACP Actor Provider
                                      SHALL:no-errorACP Actor Consulter
                                      Summaryfalse
                                      Alternate Namespatient
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      40. CommunicationRequest.about
                                      Definition

                                      Other resources that pertain to this communication request and to which this communication request should be associated.

                                      ShortResources that pertain to this communication request
                                      Comments

                                      Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.

                                      Control0..*
                                      TypeReference(Resource)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      42. CommunicationRequest.encounter
                                      Definition

                                      The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.

                                      ShortEncounter created as part of
                                      Comments

                                      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                      Control0..1
                                      TypeReference(ACP Encounter)
                                      Is Modifierfalse
                                      Obligations
                                        ObligationsActor
                                        SHALL:populate-if-knownACP Actor Provider
                                        SHALL:no-errorACP Actor Consulter
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        44. CommunicationRequest.payload
                                        Definition

                                        Text, attachment(s), or resource(s) to be communicated to the recipient.

                                        ShortMessage payload
                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        46. CommunicationRequest.payload.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
                                        48. CommunicationRequest.payload.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())
                                        50. CommunicationRequest.payload.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())
                                        52. CommunicationRequest.payload.content[x]
                                        Definition

                                        The communicated content (or for multi-part communications, one portion of the communication).

                                        ShortMessage part content
                                        Control1..1
                                        TypeChoice of: string, Attachment, Reference(Resource)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        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()))
                                        54. CommunicationRequest.occurrence[x]
                                        Definition

                                        The time when this communication is to occur.

                                        ShortWhen scheduled
                                        Control0..1
                                        TypeChoice of: dateTime, Period
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Alternate Namestiming
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        56. CommunicationRequest.authoredOn
                                        Definition

                                        For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.

                                        ShortWhen request transitioned to being actionable
                                        Control0..1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Obligations
                                          ObligationsActor
                                          SHALL:populate-if-knownACP Actor Provider
                                          SHALL:no-errorACP Actor Consulter
                                          Summarytrue
                                          Alternate NamescreatedOn
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          58. CommunicationRequest.requester
                                          Definition

                                          The device, individual, or organization who initiated the request and has responsibility for its activation.

                                          ShortWho/what is requesting service
                                          Control0..1
                                          TypeReference(ACP HealthProfessional PractitionerRole, ACP HealthProfessional Practitioner)
                                          Is Modifierfalse
                                          Obligations
                                            ObligationsActor
                                            SHALL:populate-if-knownACP Actor Provider
                                            SHALL:no-errorACP Actor Consulter
                                            Summarytrue
                                            Alternate Namesauthor
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            60. CommunicationRequest.recipient
                                            Definition

                                            The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.

                                            ShortMessage recipient
                                            Control0..*
                                            TypeReference(ACP ContactPerson)
                                            Is Modifierfalse
                                            Obligations
                                              ObligationsActor
                                              SHALL:populate-if-knownACP Actor Provider
                                              SHALL:no-errorACP Actor Consulter
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              62. CommunicationRequest.sender
                                              Definition

                                              The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.

                                              ShortMessage sender
                                              Control0..1
                                              TypeReference(ACP Patient)
                                              Is Modifierfalse
                                              Obligations
                                                ObligationsActor
                                                SHALL:populate-if-knownACP Actor Provider
                                                SHALL:no-errorACP Actor Consulter
                                                Summarytrue
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                64. CommunicationRequest.reasonCode
                                                Definition

                                                Describes why the request is being made in coded or textual form.

                                                ShortWhy is communication needed?
                                                Comments

                                                Textual reasons can be captured using reasonCode.text.

                                                Control1..*
                                                BindingFor example codes, see ActReason (3.0.0)
                                                (example to http://terminology.hl7.org/ValueSet/v3-ActReason|3.0.0)

                                                Codes for describing reasons for the occurrence of a communication.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populate-if-knownACP Actor Provider
                                                  SHALL:no-errorACP Actor Consulter
                                                  Summarytrue
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://snomed.info/sct",
                                                      "code" : "713603004"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  66. CommunicationRequest.reasonReference
                                                  Definition

                                                  Indicates another resource whose existence justifies this request.

                                                  ShortWhy is communication needed?
                                                  Control0..*
                                                  TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  68. CommunicationRequest.note
                                                  Definition

                                                  Comments made about the request by the requester, sender, recipient, subject or other participants.

                                                  ShortComments made about communication request
                                                  Control0..*
                                                  TypeAnnotation
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))